Government announces public-private anti-fraud partnership

WASHINGTON, July 26, 2012—Officials announced a fraud-fighting partnership that includes the federal government, state officials, large insurers and other groups.

An announcement by the federal Department of Health and Human Services (HHS) said the initiative will allow partners to share information and best practices so they can improve detection and prevention of fraudulent health-care billings and payments. The partnership will focus on scams that target public and private payment systems.

The partnership hopes to spot and stop payments billed to different insurers for care delivered to the same patient on the same day in two different cities, the announcement from HHS said. A potential long-range goal of the partnership is to use sophisticated technology and analytics on industry-wide health-care data to predict and detect health-care fraud.

The announcement was made by HHS Secretary Kathleen Sebelius and Attorney General Eric Holder. The following organizations and government agencies are among the partners:

• America’s Health Insurance Plans
• Amerigroup Corp.
• Blue Cross and Blue Shield Association
• Blue Cross and Blue Shield of Louisiana
• Centers for Medicare & Medicaid Services
• Coalition Against Insurance Fraud
• Federal Bureau of Investigations
• Health and Human Services Office of Inspector General
• Humana Inc.
• Independence Blue Cross
• National Association of Insurance Commissioners
• National Association of Medicaid Fraud Control Units
• National Health Care Anti-Fraud Association
• National Insurance Crime Bureau
• New York Office of Medicaid Inspector General
• Travelers
• Tufts Health Plan
• UnitedHealth Group
• U.S. Department of Health and Human Services
• U.S. Department of Justice
• WellPoint Inc.