14 caught with hands in the cookie jar

14 charged in fraud scheme

A tip from one person who refused to participate in a health insurance fraud scheme has led to the arrests of 14 people accused of stealing more than $500,000 from the State and School Employees Health Insurance Plan.

State Attorney General Jim Hood said Thursday 10 state employees conspired with three Blue Cross/Blue Shield of Mississippi workers to submit fraudulent insurance claims. The 14th person was not employed by the state or the insurance company.

In return for approving the false claims, the Blue Cross/ Blue Shield workers got kickbacks from the state employees.

Blue Cross/Blue Shield administers the state and public school employees' self-funded insured plan.

A Blue Cross/Blue Shield spokesman couldn't be reached late Thursday.

But Hood said Blue Cross/Blue Shield alerted authorities to the scheme and has reimbursed the state-funded plan.

The 14 face charges of insurance fraud, mail fraud and false representation.

Insurance fraud carries a maximum three years in prison. Mail fraud carries a maximum five years in prison.

"They need to go to jail," Hood said. "They are taking from all of us."

Hood called the case the largest theft from the employee health plan since he was elected in 2003.

"We have a hard enough time now trying to get claims paid. We don't need people stealing from taxpayers," Hood said.