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Obama Wants Private Sector to Help with Healthcare Fraud Fight

Joe Cantlupe, for HealthLeaders Media, January 29, 2010

To combat healthcare fraud, Obama Administration officials met Thursday with law enforcement, government regulators, and insurance industry representatives to take steps to improve coordination and data sharing.

Noting the "staggering" loss of an estimated $60 billion in public and private healthcare funds lost each year, Attorney General Eric Holder told a National Summit on Health Care Fraud that combating fraud is one of the most urgent destructive national challenges that the administration faces.

Human and Human Services Secretary Kathleen Sebulius said the proposed 2011 budget Obama will unveil next week will "include historic support for anti-fraud efforts that will save billions of dollars over 10 years."

The plan calls for increased investment in programs that "have a proven record of preventing fraud, reducing payment errors, and returning funds to Trust Funds," Sebulius said. "The Obama Administration has zero tolerance for healthcare fraud and abuse." No detailed monetary amounts were announced.

The daylong session in Bethesda, MD, aimed to bring together pubic and private partners to establish a cooperative, national response to fraud, which officials said needs improvement.

Sandy Praeger, commissioner of the Kansas Insurance Department, said there needs to be better cooperation among the entities in health insurance.

James Roosevelt Jr., president and CEO of Tufts Health Plan in Boston, emphasized the importance of the private sector in joining the work of fighting healthcare fraud.

"Anti-fraud efforts face enormous challenges, but we know firsthand by working together with public agencies, we can increase antifraud performance." Such a partnership has "cost and quality benefits," he said. Roosevelt suggested federal officials include the private sector more and undertake "increased sharing" of public information.

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