Switch to ADA Accessible Theme
Close Menu
Gianelli & Morris
We Fight Insurance Companies and Win

Blue Shield of California Terminates Executive Over Alleged Credential Fraud

Hands of chief medical officer ordering medicines online, typing on laptop

Blue Shield of California announced that it has involuntarily terminated Tosha Lara-Larios, one of its interim medical directors, after discovering she allegedly misrepresented her qualifications. The health insurance company reported the matter to law enforcement and is cooperating fully with the ongoing investigation, according to an article reported in the San Diego Union-Tribune on June 21st.

“We recently learned a former employee misrepresented her name and licensure, and we reported that to law enforcement,” Blue Shield of California stated. The company added that Lara-Larios had been listed as the interim vice president, chief medical officer, and medical director of medical management and accreditation before her removal.

Members of the San Diego medical community first noticed the removal of Lara-Larios’s name from the company’s online senior leadership roster. An archived version of the webpage indicated that she had claimed to hold a doctorate in osteopathic medicine. However, a search of the Osteopathic Medical Board of California’s licensing database revealed no record of such a person. Further, a nationwide identification search found no records of Lara-Larios in any context, raising questions about her true identity and qualifications.

Blue Shield clarified that Lara-Larios’s role was primarily administrative and that she did not treat patients during her employment. “It’s important to note that, while employed at Blue Shield of California, this person’s role was primarily administrative,” the company stated. Despite the administrative nature of her role, Lara-Larios had been quoted in a heart health bulletin issued on February 8, where she provided standard health advice under the title “Dr. Tosha Lara-Larios.”

The company’s statement underscored the seriousness of the situation: “Because this is an active fraud investigation and a personnel matter, we cannot discuss more details at this time. We are confident the authorities will conduct a thorough investigation, and we are committed to supporting that effort.”

Blue Shield, which insures about 4.8 million Californians, has not provided further information on how Lara-Larios managed to bypass the vetting processes typically used by large corporations to verify the qualifications of their employees, especially those in high-ranking positions. This incident highlights potential vulnerabilities in these processes and raises questions about the effectiveness of current verification methods.

Facebook Twitter LinkedIn
Designed and Powered by NextClient

© 2021 - 2024 Gianelli & Morris, A Law Corporation. All rights reserved.
Custom WebShop™ law firm website design by NextClient.com.


It appears you don't have Adobe Reader or PDF support in this web browser. Click here to download the PDF.