Insurers Join HHS in Fighting Healthcare Fraud

Margaret Dick Tocknell, for HealthLeaders Media , July 27, 2012

HHS Secretary Kathleen Sebelius and Attorney General Eric Holder announced the partnership at the White House with insurance executives in attendance. "This partnership puts criminals on notice that we will find them and stop them before they steal healthcare dollars," Sebelius said  in a press statement.

Health insurers participating in the partnership include Amerigroup, Blue Cross and Blue Shield of Louisiana, Humana, Independence Blue Cross, Tufts Health Plan, UnitedHealth Group, and WellPoint. The Blue Cross and Blue Shield Association and America's Health Insurance Plans are also participating.

The partnership's operational structure and initial work plans are still being developed. In a nod to patient privacy issues that could derail the program, an HHS official noted that many "delicate technical and legal questions need to be worked through in ways that work for a whole complex of public and private organizations."

Work will be divided among three committees: executive, data analysis and review, and information sharing, which will begin meeting in September.

The budget for the program has not been set, although the monies will come from HHS's antifraud funds.

The Patient Protection and Affordable Care Act provides guidance for the partnership in identifying high risk providers and suppliers. According to an HHS official the highest level of risk includes new home health and new durable equipment providers and suppliers.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.

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