Government Signs on Insurers to Fight Healthcare Fraud
President Barack Obama’s administration launched a new partnership with private insurance companies, state officials and other stakeholders to scale up efforts to tackle widespread and increasingly sophisticated healthcare fraud.
Speaking from the White House at a table surrounded by leaders from many of the country’s biggest health insurers, Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder launched the new initiative, which builds on past efforts to root out crimes that cost U.S. taxpayers billions of dollars every year.
“Bringing additional healthcare industry leaders and experts into this work will allow us to act more quickly and effectively in identifying and stopping fraud schemes, seeking justice for victims, and safeguarding our healthcare system,” Holder said.
The project increases a focus on data sharing between public and private health insurers, using new technology that helps track medical claims in real time. Many large insurers have already signed onto the program, including Humana Inc, UnitedHealth Group and WellPoint Inc.
“In the past, we followed a †pay-and-chase’ model, paying claims first - then only later tracking down the ones we discovered to be fraudulent. Now, we’re taking away the crooks’ head start,” Sebelius said.
Over the past two years, Holder and Sebelius have sought to identify major centers of healthcare fraud, meeting with local organizations, investigators, prosecutors and state officials to better understand the nature of common fraud schemes and to bring new stakeholders into the conversation.