HHS announces new healthcare fraud initiative

Health and Human Services (HHS) officials last Thursday announced a public-private partnership of organizations dedicated to improving the detection and prevention of fraudulent billings.

The federal government joins state officials, several private health insurance companies and other anti-fraud groups in a collaborative effort to protect tax payers and consumers. One of the partnership's goals is to tag duplicate billings for the same care to the same patient on the same day in different locations.

This partnership can take advantage of enforcement tools provided by the Affordable Care Act: tougher sentences for people convicted of healthcare fraud, the ability to suspend payments to providers and suppliers suspected of fraudulent activity and enhanced screenings.  More than $10 billion has been recovered over the past three years.

Among the government and private organizations and trade groups currently participating in this initiative are America’s Health Insurance Plans, Blue Cross and Blue Shield Association, CMS, Coalition Against Insurance Fraud, FBI, OIG, UnitedHealth Group and others.

Topics: Medicare/Medicaid