Highmark Inc., Federal Bureau of Investigation (FBI) team up to stop seniors from falling victim to fraud

PITTSBURGH (April 29, 2024) — Americans over age 60 are increasingly falling victim to fraud schemes perpetrated online and over the phone. According to the latest FBI Elder Fraud Report, financial fraud for those individuals accounted for $3.1 billion total losses and 88,262 complaints filed. Because of this, Highmark’s Financial Investigations and Provider Review (FIPR) Department and the Federal Bureau of Investigation (FBI) are joining together to provide new resources to educate and stop seniors from falling victim to national ploys.

“Our FIPR team is dedicated to protecting our more than 7 million members and their health care dollars from all forms of fraud,” says Kurt Spear, vice president of FIPR for Highmark. “Elder fraud is a prevalent scheme that affects families across the nation, and we are proud to partner with the FBI to bring awareness and education to preventing it.”

Forms of elder fraud include romance, tech support, grandparent, and lottery scams. In all these schemes, victims are asked for personal information and for money to be wired immediately.

Highmark’s FIPR and the FBI partnered to create a video that explores the harms of elder fraud on seniors and their families. The video features real-life, personal stories of fraud, educational resources, and various tools available that focus on prevention for seniors and care givers. The video can be viewed here.

“Empowering our seniors with education and awareness surrounding elder fraud schemes is critical as a first line of defense,” said FBI Pittsburgh Special Agent in Charge Kevin Rojek. “The devastating effects of these schemes go far beyond financial losses, robbing people of their sense of security. The FBI and our partners believe today’s announcement sends a clear message: we remain vigilant in protecting our seniors and we will aggressively pursue those who believe they can exploit members of our community.”

Highmark’s FIPR department has made a cumulative financial impact of more than $1.6 billion in savings related to claims errors, fraud, waste and abuse since 2017. FIPR utilizes an internal team that includes registered nurses, investigators, accountants, former law enforcement agents, clinical coders and programmers, complemented by an array of industry-leading vendors, to complete its objectives.

“Fraud among vulnerable populations like seniors has become more common in recent years,” says Melissa Anderson, chief risk, audit and compliance officer for Highmark Health. “FIPR continues to combine innovative technology, the knowledge and experience of a multi-disciplinary team, and community partnerships to do right by our customers and stay ahead of bad actors.”

To avoid becoming a victim of elder fraud, the FBI recommends following these tips:

• Be careful what you post online. Scammers can use details shared on social media platforms and dating sites for targeting purposes.
• Be suspicious of telephone calls that require you to immediately take action and request bail money for a family member in distress.
• Be careful with caller IDs that look familiar. Scammers may use technology to disguise the actual number they are calling from and make it appear as a trusted number.
• Never give personally identifiable information or money to anyone you have only communicated with by telephone or online.

The FBI’s IC3 receives and tracks thousands of complaints daily, reported by victims of fraud. Any person age 60 or older could be considered a victim of Elder Fraud. IC3 reporting is key to identifying, investigating, and holding those responsible accountable for their actions. If you, or someone you know, is a victim of a fraud or scam, file a complaint with IC3 or call the National Elder Fraud Hotline at 1-833-372-8311.

Highmark and the FBI will together host in-person classes at Highmark Direct Stores educating seniors and families on elder fraud and ways to prevent it. Initial classes will be held on the following dates:

• Monday, June 17^th at 2:00 p.m. – 1775 North Highland Road, Pittsburgh, PA 15241
• Thursday, June 27^th at 2:00 p.m. – 4885 McKnight Road, Pittsburgh, PA 15237