health insurance fraud
Coverage of health insurance fraud in the Nexus archive.
- Kenya: SHA Introduces Fingerprint Verification for Children Aged 7-17 to Curb Health Insurance Fraud
The Social Health Authority (SHA) in Kenya has introduced biometric fingerprint identification for registered child dependants aged 7-17 to strengthen beneficiary verification and reduce fraud in the public health insurance system.
- Minnesota orders $150K fine for health insurance company charged in fraud scheme
The Minnesota Department of Commerce fined Seguro Medico and its owner Arthur Walsh $150,000 for misleading consumers about health insurance coverage by selling plans with limited benefits. A 2025 federal indictment alleged the company and Walsh engaged in a nationwide bait-and-switch scheme involving unlicensed agents and wire fraud.
- STAT+: This whistleblower took on a health insurance giant and a political machine. She’s not stopping there
Chris Deacon, a former official overseeing New Jersey’s health plan, played a key role in uncovering Horizon Blue Cross Blue Shield's alleged overpayment of hospitals and doctors, leading to a $100 million settlement. Despite the settlement, Deacon felt conflicted as officials erased her contributions and downplayed their own accountability.