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Insurers Join HHS in Fighting Healthcare Fraud

Margaret Dick Tocknell, for HealthLeaders Media, July 27, 2012

Acknowledging a fragmented system that has enabled "fraudsters to take advantage," the Department of Health and Human Services is again ratcheting up its efforts to uncover healthcare fraud.

HHS announced Thursday that more than 20 groups, including state and local officials, public and private payers, and federal law enforcement agencies, will be part of public-private partnership whose primary goal will be to share experiences in uncovering and thwarting healthcare fraud.

The partnership will share information on fraud trends and best practices to help law enforcement agencies more effectively tackle the fraud challenge. The initial focus is expected to be on specific schemes, billing codes, and geographic hotspots popular with fraudsters. A long-range goal is to use technology and data analytics to predict and detect Medicare and other fraud schemes.

Healthcare fraud costs the country an estimated $80 billion each year, according to the Federal Bureau of Investigation.

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