Former Blue Cross employee arrested on state fraud charges

March 16--A 33-year-old ex-Blue Cross Blue Shield of Florida business analyst was arrested after hundreds of medical service claims were submitted for services that never occurred, according to the state Department of Financial Services' Division of Insurance Fraud.

Frank John Leli of Atlanta was booked March 9 on charges of insurance fraud, grand theft and organized scheme to defraud. His bail was set at $150,000, and he bonded out later that day, according to jail records.

State officials said Blue Cross began investigating Leli in August 2014 when the company noticed 27 medical claims filed on his behalf over a short period of time, all related to treatments by a Jacksonville-based marriage and family therapist. Blue Cross contacted the therapist, who verified only 12 of the 27, according to state insurance fraud officials.

The company completed its internal investigation in November and notified state insurance officials of the results. The state continued to look into Leli and uncovered more claims he filed on other treatments by two Georgia-based chiropractors. Both chiropractors told investigators that he was neither a current or past patient, according to state officials.

The investigation concluded that Leli submitted almost 350 claims, with only 12 found to be legitimate and almost $40,000 in insurance benefits collected, state officials said.

The Georgia Bureau of Investigation and Blue Cross Blue Shield assisted in the Florida investigation. If convicted, Leli could face up to 15 years in prison, according to the Division of Insurance Fraud.

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