Last week Health and Human Services (HHS) Secretary Kathleen Sebelius and Attorney General Eric Holder announced the launch of an innovative partnership among the federal government, State officials, several leading private health insurance organizations, and other health care anti-fraud groups to prevent health care fraud. This partnership is the Obama Administration’s next step in fighting fraud, designed to compliment the various new tactics implemented since the passage of health care reform in 2010.
According to last week’s press release, the new partnership will help public and private entities share information and best practices in order to better detect and prevent the payment of fraudulent claims. It aims to halt scams that cut across a number of public and private payers and help law enforcement officials more effectively identify and prevent suspicious activities, better protect patients’ confidential information and use the full range of tools and authorities provided by the Affordable Care Act and other laws to combat and prosecute illegal actions.
One goal of this partnership is to develop the ability to spot and stop payments billed to different insurers for care delivered to the same patient on the same day in two different cities. Another potential long-range goal is to use technology and analytics on industry-wide healthcare data to predict and detect health care fraud schemes.
In the last 3 years, the Administration’s efforts have resulted in a record-breaking $10.7 billion recovered from health care fraud.