California – Medicare beneficiaries are being urged to stay alert as fraud schemes grow more complex and increasingly target older adults and their personal information.
During Medicare Fraud Prevention Week, Blue Shield of California is emphasizing the steps members can take to recognize suspicious activity, protect their health plan information and report possible scams. The warning comes as healthcare fraud continues to affect patients and taxpayers across the country.
The scale of the problem was underscored in 2025, when the U.S. Department of Justice carried out what it described as the largest healthcare fraud takedown in history. Authorities charged 324 people, including 96 medical professionals, in alleged schemes involving more than $14.6 billion in false claims. The cases included accusations involving fraudulent telemedicine arrangements and identity theft.
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“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.”
Among the warning signs are medical supplies delivered without being ordered, such as diabetic supplies, catheters or back braces. Beneficiaries should also be cautious of callers pretending to represent a health plan, charges for tests or services never received, and newer schemes involving artificial intelligence, stolen identities or fabricated medical records used for billing.
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Blue Shield said its Special Investigations Unit works to detect healthcare fraud by reviewing suspicious activity and identifying billing patterns that do not match patient needs. The team includes fraud examiners, coders and auditing experts who use data analytics to help flag questionable claims.
Members are encouraged to examine their Explanation of Benefits statements for unfamiliar charges, protect their health plan cards and avoid sharing Medicare numbers, Social Security numbers or other personal details over the phone or online unless they are certain of the recipient’s identity. A caller ID that appears legitimate should not be treated as proof that a call is safe.
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Anyone who loses a health plan ID card should report it immediately and request a replacement card and new identification number. Beneficiaries who notice services they did not receive or other suspicious charges should contact their health plan.
Blue Shield Medicare members and caregivers may report suspected fraud by calling (855) 331-4894 (TTY: 711) or emailing [email protected]. Additional fraud prevention information is available through Blue Shield’s online fraud prevention resources.