Anthem investigates Lap-Band centers for fraud

Anthem Blue Cross Blue Shield is investigating whether several weight-loss surgery centers have been involved in health insurance fraud.

California's largest for-profit insurer said it's conducting an investigation into whether Lap-Band surgery centers, which are affiliated with the 1-800-GET-THIN campaign, have defrauded its members, reported KPCC.

"I can confirm that we are working with the authorities on this issue," Anthem spokesperson Darrell Ng told FierceHealthPayer. "Because it is an ongoing investigation, we will decline to provide any more information at this time."

Anthem is the second California insurer to probe certain Lap-Band surgery centers. Aetna said in January that it's helping the state Department of Insurance determine whether certain Lap-Band surgery centers engaged in insurance fraud.

The Aetna-state investigation follows other local and federal agencies, including the U.S. Food and Drug Administration and the Los Angeles County Board, that are examining the Lap-Band centers' ads for potential misleading advertising and risks of the weight-loss surgery, according to the Los Angeles Times.

Meanwhile, four former Lap-Band doctors have sued the centers, claiming the centers stole their idenities as part of a medical fraud scheme. But a Lap-Band spokesman denied any wrongdoing in that case and said the company hasn't been contacted by Anthem or Aetna and is not aware of any investigation about the centers, KPCC noted.

To learn more:
- read the KPCC article
- see the Los Angeles Times article

Related Articles:
Healthcare fraudsters get stiff sentences
Fraud prevention: Do you know what the criminals are up to?
Feds probe Humana on claims, doc loans
Insurers step up efforts to fight fraud
WellCare to pay $138M in Medicare fraud settlement