Reporting private health care insurance fraud

Health care fraud against private insurance companies is rampant. The best way to stop it is for patients to report it to the insurance company being defrauded or to the FBI.

One of the best places to find out how to report the fraud to the insurance company itself is the website of the National Health Care Anti-Fraud Association (NHCAA), at www.NHCAA.org. The NHCAA website has a listing of all of the private insurance companies, complete with websites and telephone numbers to contact them directly. See https://www.nhcaa.org/resources/health-care-anti-fraud-resources/report-health-care-fraud.aspx.  

NHCAA also has a listing for each State the contact information for the State Insurance Fraud Bureau and State Medical Boards for you to contact for more information or for reporting violations directly to those organizations. See https://www.nhcaa.org/resources/health-care-anti-fraud-resources/state-insurance-fraud-bureau.aspx.  

You can also report private health insurance fraud to the FBI, which has jurisdiction over both federal and private insurance programs. See https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud.

Although there is no monetary reward for reporting fraud against private insurance companies, you may find it rewarding to take a bite out of fraud and help preserve our limited health care dollars.

Below is a list of the 25 largest private health care insurance companies in the United States:

  • Unitedhealth Group
  • Wellpoint Inc. Group
  • Kaiser Foundation Group
  • Humana Group
  • Aetna Group
  • HCSC Group
  • Cigna Health Group
  • Highmark Group
  • Coventry Corp. Group
  • HIP Insurance Group
  • Independence Blue Cross Group
  • Blue Cross Blue Shield of New Jersey Group
  • Blue Cross Blue Shield of Michigan Group
  • California Physicians’ Service
  • Blue Cross Blue Shield of Florida Group
  • Health Net of California, Inc.
  • Centene Corp. Group
  • Carefirst Inc. Group
  • Wellcare Group
  • Blue Cross Blue Shield of Massachusetts Group
  • UHC of California
  • Lifetime Healthcare Group
  • Cambia Health Solutions Inc.
  • Metropolitan Group
  • Molina Healthcare Inc. Group