7 instances of misconduct since 1995 | $59.3M in penalties
Pittsburgh, Pa.-based Highmark is one of the largest health insurers in the United States. Highmark serves about 34.4 million people across the country through health, dental, vision, and customized supplemental health products and services. Highmark also helps federal and state agencies administer their public health programs, including Medicare. Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield).
|Letter to Highmark||3/16/2013|
7 Instances of Misconduct since 1995
1 additional instance of misconduct pending resolution.
Violation of Pennsylvania Nonprofit Law
Royal Mile Company, et al. v. UPMC, et al. (Conspiracy to Monopolize Health Ins. Market)
Love, et al. v. Blue Cross and Blue Shield Assoc., et al. (RICO)
Turpin v. Highmark (EOB Form Noncompliance With ERISA)
U.S. ex rel. Drescher v. Highmark (Medicare Program False Claims)
Veritus Medicare Services False Claims
Medicare Program False Claims
U.S. v. Krafsig-Kearney (False Statements)