Nonprofit health plan urges vigilance against suspicious charges, medical supplies, and services not received

OAKLAND, Calif., June 1, 2026 /PRNewswire-HISPANIC PR WIRE/ — In observance of Medicare Fraud Prevention Week, Blue Shield of California is highlighting its commitment to safeguarding Medicare beneficiaries against scams and fraudulent activities. With healthcare fraud continuing to rise across the country, affecting both patients and taxpayers, protecting older adults has never been more critical.

In 2025, the U.S. Department of Justice executed the largest healthcare fraud takedown in history, charging 324 individuals — including 96 medical professionals — in schemes involving more than $14.6 billion in alleged false claims, including fraudulent telemedicine and identity theft.

“Medicare fraud and scams are becoming more sophisticated with the use of advanced technology,” said Alex Uhm, Medicare vice president and general manager at Blue Shield of California. “We’re focused on protecting our members and equipping them to recognize and report suspicious activity.”

Blue Shield’s offers updated education on common fraud schemes and preventive measures, and an online portal for members to report suspected fraud.

Additionally, Blue Shield’s Special Investigations Unit (SIU) is dedicated to detecting healthcare fraud and flagging suspicious activity. This highly specialized team brings together coders, fraud examiners, and auditing experts who use data analytics to identify billing patterns that don’t align with patient needs. This proactive approach helps keep members safe and ensures fraud is addressed quickly.

Blue Shield’s Special Investigations Unit teams tackle fraud across all areas, but common scams targeting older adults include:

• Unsolicited medical supplies: Receiving items such as catheters, diabetic supplies, or back braces delivered without requesting.
• Impersonation scams: Fraudsters posing as health plan representatives to obtain personal information.
• Phantom billing: Charges for services or tests that were never provided.
• Artificial intelligence (AI)-driven fraud: Emerging tactics include the use of stolen beneficiary information to submit false claims, or fake member or provider identities to fabricate medical records for billing purposes.

Blue Shield encourages its members to:

• Review statements: Check Explanation of Benefits (EOB) statements for any unfamiliar charges.
• Protect personal information and be cautious with calls: Avoid sharing personal details over the phone or online, unless certain of the recipient’s identity. Even if the caller ID looks legitimate, do not confirm any personal information such as your Medicare number or social security number over the phone.
• Protect your health plan card: Never loan your health plan card to anyone.

Medicare beneficiaries who suspect fraud or scams are also encouraged to take these actions:

• Contact your health plan: Use the phone number on your health plan card to report any suspicious activity.
• Report lost or stolen ID cards: Inform your health plan immediately if your ID card is lost or stolen and request a new card and ID number.
• Report suspicious activity: Immediately report any unfamiliar charges or services not received to the health plan Special Investigations Unit (SIU). If older adults or their caregivers suspect fraud, call Blue Shield’s Medicare fraud hotline at (855) 331-4894 (TTY:711) or email [email protected]. 

For more tips on how to stay safe from healthcare fraud, visit:
https://www.blueshieldca.com/en/home/about-blue-shield/preventing-fraud

About Blue Shield of California
Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. The health plan is a tax paying, nonprofit, independent member of the Blue Shield Association with nearly 6 million members, over 6,500 employees and more than $28 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $60 million to Blue Shield of California Foundation in the last three years to have an impact on California communities.

For more news about Blue Shield of California, please visit news.blueshieldca.com. Or follow us on LinkedIn or Facebook.

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SOURCE Blue Shield of California