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| | New Anti-Fraud Partnership Aimed At Dismantling Medical Insurance Schemes By Press Release Edited By Lonce LaMon - July 27, 2012
A new anti-fraud partnership uniting the public and private insurers creates a strong force multiplier and national strategy to increase upward pressure on fraud rings and downward pressure on medical premiums, the Coalition Against Insurance Fraud said just this past Wednesday, July 25th.
“A dawning era of cooperation unleashes a national effort to eradicate fraud. Information-sharing is critical to stripping back the veil of secrecy allowing many fraud rings to operate. A joint effort will apply huge and hopefully fatal pressure on crime rings and their costly schemes,” said Dennis Jay, the Coalition’s executive director and a member of the new partnership’s executive board.
The Fraud Prevention Partnership was announced in Washington on Wednesday. It is based on information sharing between public and private insurers. Increasingly, the same dishonest medical providers are defrauding private auto, workers compensation, and health insurers but also taxpayer-funded programs such as Medicare and Medicaid, Jay says.
Jay congratulated HHS Secretary Kathleen Sebelius and Attorney General Eric Holder for taking this bold step. Jay urged all partners to be actively engaged in the effort’s success.
When fraud fighters from all sectors compare case leads, evidence and other information, many hidden schemes will break open. This high level of collaboration greatly increases the chances of earlier detection and successful prosecution.
Over time, the coordination of anti-fraud intelligence and strategy will help shut down more medical schemes involving health, auto and workers compensation. This is true whether they’re large, national fraud rings or individual providers, Jay predicts. Continued success will begin to apply downward pressure on health premiums and on the government expenses for healthcare.
In the short term, this will be important for policyholders and public insurers that face greater financial squeeze in a tight economy. Over the long term, the increased force has potential to reduce health fraud altogether. It’s a stubborn crime that has resisted other efforts to eradicate it, so the new partnership will be a sound, well-organized effort to break this logjam, Jay predicted.
With an increased presence of organized crime in health fraud, the urgency of swift action grows even higher.
Some estimates peg Medicare fraud alone at $60 billion annually in theft annually. All healthcare fraud could reach $80 billion the FBI says.
“The partnership’s timing comes at a pivotal moment. Fraud rings are surfacing that try to steal several hundred million dollars apiece. How many more mega-rings are operating, and are their huge thefts creating a new norm for defrauding health-related insurers?” Jay asks.
The partnership includes Health & Human Services, the Department of Justice, the National Association of Insurance Commissioners, private health plans, property & casualty insurers and major anti-fraud organizations.
The Coalition is a nonprofit alliance of insurers, consumers and government agencies fighting all forms of insurance fraud.
Jim Quiggle
Director of Communications
Coalition Against Insurance Fraud
1012 14th Street, NW Suite 200
Washington, DC 20005
202-393-7331 w
202-537-1878 h
jamesq@insurancefraud.org
www.InsuranceFraud.org
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