HHS, feds announce new anti-fraud initiative
HHS and the U.S. Justice Department have partnered with about a half-dozen health insurers to help prevent fraud and abuse in healthcare billing. The initiative is designed to share information on specific schemes, billing codes and even geographical hotspots that have been used in fraudulent activity. The government hopes, for example, to be able to immediately detect when payments are billed for the same patient in two different cities on the same day. The initiative will use advanced technology and data analytics to identify when and where healthcare fraud is occurring, according to an HHS news release. Trade group America’s Health Insurance Plans is participating in the partnership with the Blue Cross and Blue Shield Association as well as health plans including Humana, UnitedHealth Group and WellPoint. A total of 21 groups, representing federal, state and private payers, have signed on so far. “By sharing data, information and best practices across all payers, this partnership will ensure the public and private sectors are even better equipped to fight fraud and will provide a powerful deterrent to would-be perpetrators looking to prey on patients and steal money from taxpayers,” AHIP President and CEO Karen Ignagni said in a statement. Healthcare fraud detection has been a significant priority of the Obama administration, which has seen a record-breaking $10.7 billion in recoveries during the past three years, according to HHS.