Evidence suggests that people are luring Native Americans away from the Wind River Indian Reservation or other Wyoming communities with the promise of out-of-state drug treatment, then placing them in illegitimate treatment facilities and billing their insurance, a local insurance company says.
This evidence came from an unusual uptick in Native-American-specific insurance plan enrollments, strange billing and communication procedures by out-of-state companies claiming to be treatment providers, and tales from patients’ family members.
That’s according to Blue Cross Blue Shield Government Affairs Principal Kelsey Prestesater, and general counsel Raymond “Rocky” Redd, who spoke with Cowboy State Daily in a Wednesday interview.
“It is a Wyoming problem, even though a lot of the bad actors are operating in the state of California,” said Redd.
“What we’ve seen,” he continued, “is that these fraudulent entities are willing to pay other people to recruit homeless individuals, or individuals on Native American reservations in dire straits, to come to their facilities – to get health insurance reimbursement.”
The operatives of the alleged scheme will find substance-addicted people on Wyoming’s reservation, the Wind River Indian Reservation, or at shelters.
Promising “good weather and appropriate treatment,” operatives give the people a one-way travel ticket to California, generally, or other states including Florida and Arizona, Prestesater told Wyoming’s legislative Tribal Relations Committee during a meeting in Fort Washakie on May 22, 2025.
But once the people arrive at the facilities, they are often “rundown apartment complexes with no appropriate treatment,” Prestesater related from her company’s investigations. They may even be allowed to use addictive substances while they’re there.
“Sometimes they’re being abused,” she added in her Wednesday interview. “When they asked questions about treatment or said they wanted to leave, they’d be stranded with no way home.”
When Blue Cross Blue Shield personnel would call the facilities to speak with the patient, a facility staffer would speak for the patient, rather, and say he or she could not take the call, Prestesater added.
Prestesater said Amy Scharaswak, BCBS Wyoming Director of Population Health, Care Delivery & Coordination, has been working with alleged victims of the scheme whom the company has been able to identify.
Prestesater and Redd said a health care provider on the reservation has confirmed that people came to the reservation and were “recruiting” vulnerable people to go receive treatment.
The CEO of that facility did not return a Cowboy State Daily voicemail request for comment by publication time.
Kim Harjo, Northern Arapaho Business Council Co-chair, confirmed last week to the committee that some Northern Arapaho Tribal members have been victims of such schemes.
The Mystery
It’s still unclear whether this scheme has anything to do with a 2023 incident in which a group of unknown people dropped at least 15 Riverton-area “hardened inebriates” off at Casper’s Wyoming Rescue Mission shelter, overwhelming it, Harjo said.
Harjo claimed to the committee that the two themes are connected.
Wyoming Rescue Mission executive director Brad Hopkins told Cowboy State Daily on Wednesday that that worry was on his mind at the time, but that he doesn’t know if the incident is connected with the scheme, or how his shelter could possibly be used as a link in that.
Hopkins said he sent a national media story about schemes similar to the one BCBS is now describing in Wyoming, to Casper’s then-police chief.
Hopkins still hasn’t solved the mystery of why so many Riverton-area residents showed up at the Casper shelter at once, he said.
Some of them left the shelter when they learned it wasn’t a residential substance-abuse-treatment facility, as someone had reportedly promised them, he said. Many meandered onto the streets of Casper.
BCBS told Cowboy State Daily on Wednesday that it, also, does not know if whoever dropped those people off was connected to the fraud scheme.
As for Hopkins, the prospect concerned him. He said he knew of a Native American shelter resident who, about eight months ago, kept saying that he had a “tribal connection” to receive treatment in California – and Hopkins hasn’t seen that man since then.
This issue is “certainly something to keep an eye on,” said Hopkins.
When the massive influx happened, Wyoming Rescue Mission workers tried their best to “welcome with open arms” the ones who chose to stay, he said, adding it’s their “heart” to help people break free of their oppressive circumstances.
Committee Co-Chair Cale Case, R-Lander, said Thursday he’s still bothered by the incident and believes whoever dropped those people off was acting inappropriately.
Hundreds
Blue Cross Blue Shield has identified hundreds of victims of the scheme and around 70 suspicious providers, Prestesater told Cowboy State Daily.
But, Redd clarified, the providers are often LLCs which a person can set up quickly, and many or all of the 70 may be associated with the same few “bad actors.”
BCBS first became aware of the issue at the end of 2024 and the beginning of this year, when personnel received phone calls from insurance enrollees and their family members, saying patients were stranded in other states and couldn’t get home, said Prestesater.
They also noticed an uptick in Native-American-plan specific insurance enrollments by Wyoming residents on the federal insurance exchange, she said.
Because Wyoming doesn’t run its own insurance exchange, BCBS must work directly with the U.S. Centers for Medicare and Medicaid Services (CMS) when raising fears about fraudulent enrollments, or making requests to disenroll an illegitimate account, Redd noted.
That also means the exchange isn’t as tightly regulated as other states’ locally-run exchanges, he added.
There are advantages to having someone enroll in a plan specific to federally-recognized Indian tribe members, Prestesater said. For example, tribal enrollees don’t have to wait for an open enrollment phase. They can change their plan frequently without reason.
And there’s another kink in the investigation, she said: Most of the new surge in enrollments appear fraudulent.
BCBS has identified around 1500 enrollments through the marketplace recently identified with claims related to residential treatment centers. Of those, only 50-70 have been identified as real people, said Prestesater.
Some were confirmed fraudulent, she added: associated with deceased people’s social security numbers or a fake driver’s license, she added.
Prestesater said that makes it everyone’s problem.
“If Blue Cross is forced into a situation where we’re paying millions in claims (to fake people) then health care gets more expensive – not just for the everyday person, but for businessowners, to be able to provide to their employees as well,” she said.
Redd said BCBS has reported this issue to everyone it can: federal and local law enforcement, the governor’s office, the federal delegation, and now the Wyoming Legislature.
Then Leave
Scharaswak gave a specific anecdote to the committee, from a person with whom she said she’s been working.
A man was “almost held against his will” at a facility, as the people running it wouldn’t give his wallet and driver’s license back to him so he could leave, said Scharaswak.
He wasn’t receiving counseling or medical oversight; he had a diagnosed mental illness but wasn’t receiving medication, she added.
One day, he called Blue Cross Blue Shield to report his circumstances, Scharaswak added. When the insurance team tried to reach him the next day, he was standing in an airport with his belongings and a plane ticket, “because the facility personnel had overheard his conversation” with BCBS, said Scharaswak.
“We keep hearing these narratives over and over again,” she added.
The Ask
During Thursday’s meeting, BCBS asked lawmakers to consider reviving a bill that died in the 2025 legislative session, which would have given insurers civil protections for reporting suspected fraud.
Redd said he’d also studied other states’ laws, allowing insurance companies to stop making payments to a fraudulent actor if it they have credible information of fraud.
In Wyoming, BCBS is subject to payment and appeal deadlines. Sometimes the company will ask a provider for records so it can investigate the provider for fraud, he said.
“We have 45 days to sift through (the records),” said Redd. “They’ll send us thousands of pages.”
He said legislation letting the company pause its payment deadlines to investigate fraud would be helpful.
Case and Sen. Eric Barlow, R-Gillette, both said they’d consider the issue in their roles on other committees.
Clair McFarland can be reached at clair@cowboystatedaily.com.
