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General News    H3'ed 3/10/11

Blue Cross and Blue Shield's Hiring Practices Let Criminals Through the Cracks

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Roger Shuler
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As for Mike McGarity, whoever said "love thy neighbor" never met this guy. And apparently, BC/BS didn't bother to check out his criminal history before hiring him, in 1984 or thereabouts. It's not like his record is a secret; after he started causing my wife and me all kinds of legal headaches, I did some research and found it easily--a matter of public record.

A company with the resources of BC/BS couldn't have done a background check on the guy? Or did the company do a background check and hire him anyway? BC/BS just enjoys hiring criminals?

Well, that's not how it's supposed to work. The various "Blues" around the country have long had problems with employee fraud. Former Blue Cross employees were sentenced in 2009 for their role in a major South Carolina fraud scheme.

The issue of fraud is particularly sensitive at BC/BS of Alabama, which is a regional Medicare administrator. Because of fraud concerns, government agencies such as the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) have paid close attention to the hiring practices of Medicare contractors, such as BC/BS of Alabama.

In fact, the CMS manuals for claims-administration contractors recommends that "the employment application provide for the applicant's signed acknowledgement that falsification of his application could be cause for dismissal at any time after employment."

Is this serious business? Oh, yes. The hiring practices of Medicare contractors has been the subject of investigations by the U.S. Government Accounting Office (GAO) and the U.S. House of Representatives. One report was titled "Improprieties by Contractors Compromised Medicare Program Integrity." Another was titled "HCFA Oversight Allows Contractor Improprieties to Continue Undetected."

In short, the documents indicate that the "Blues," because of their problems with fraud, are not supposed to be hiring folks with criminal backgrounds. So why is Mike McGarity employed at Blue Cross and Blue Shield of Alabama?

It's not like his criminal record is small. He has at least eight convictions, and those were just the ones I could find--from checking Alabama, Jefferson County, and Birmingham records. That doesn't count the numerous other jurisdictions in metro Birmingham alone. And they don't count a drug-possession charge for which he confessed guilt, but the case was nol-prossed.

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I live in Birmingham, Alabama, and work in higher education. I became interested in justice-related issues after experiencing gross judicial corruption in Alabama state courts. This corruption has a strong political component. The corrupt judges are (more...)
 
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