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Newly Formed Consortium to Combat Medical Fraud Announces National Agenda to Intensify Fight Against Health Care Fraud Goals: Collaboration Across Industries; Alignment of Resources; Increased Awareness Among Public and Private Stakeholders Including Fede
Date:6/24/2008

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"These criminals are smart -- they leverage cutting-edge technology to probe for the soft under- belly of the health care system. As a result, we need to modernize our approach to combating them," stated Dennis Jay, Executive Director, Coalition Against Insurance Fraud.

To that end, the Consortium will engage in specific activities such as:

* Joint educational programs designed to help property/casualty insurance and health insurance investigators learn each others techniques and strategies in order to encourage cooperation across lines of insurance in detecting and investigating fraud;

* Cross-matching claims and other types of data used by property/casualty and health insurance companies to better detect fraudulent schemes as well as collaborating to build stronger cases against criminals;

* Industry-wide research focused on gathering information across lines of insurance to better understand the current trends seen in insurance fraud. Specifically, the first study will focus on state medical boards to evaluate how well they are disciplining licensees who commit fraud.

"Those that perpetrate medical insurance fraud are sophisticated criminals, it is the job of law enforcement and the private sector to thwart their efforts to defraud. The collaborative efforts of both the public and private sector, such as working with the NHCAA and the Consortium, is one of the tools that is available to the FBI to investigate those committing medical insurance fraud," stated Robert Montemorra, Chief of the Federal Bureau of Investigation's Health Care Fraud Unit.

"The Department of Justice is committed to fighting health care fraud in both the public and private sectors," said Steve Tyrell, Chief of the Criminal Division's Fraud Section at the U.S. Department of Justice. "As more people enroll in the Medicare program and private health care plans and the amount of money spent on health care continues to rise, so too does the importa
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SOURCE National Health Care Anti-Fraud Association
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