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Administration Launches New Effort Against Healthcare Fraud

By Elise Viebeck

Source: thehill.com

The Obama administration announced a new plan to crack down on healthcare fraud, which costs taxpayers and industry tens of billions of dollars per year.

Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius said the new effort will cut down on illicit healthcare billings by coordinating public and private fraud-fighting.

Health insurers have been at odds with the administration over parts of the Affordable Care Act, but several have signed on to the new effort, including WellPoint, UnitedHealth Group and the industry’s main lobby, America’s Health Insurance Plans (AHIP).

AHIP President and CEO Karen Ignagni called the partnership a “major step forward in the fight against fraud and abuse.”

“By sharing data, information, and best practices across all payers,” she said in a statement, “this partnership will … provide a powerful deterrent to would-be perpetrators looking to prey on patients and steal money from taxpayers.”

Details of the expected collaborations were not released, but the announcement described how stakeholders might curb fraud by sharing information on specific schemes.

Better coordination could avert the payment of an illicit claim billed to multiple insurers, for example.

“Bringing additional healthcare industry leaders and experts into this work will allow us to act more quickly and effectively in identifying and stopping fraud schemes,” Holder said in a statement.

He praised the Obama administration’s efforts on healthcare fraud, which have recovered $10.7 billion over the last three years, according to the federal Health department.

Sebelius said the healthcare law has made better tools available to combat fraud, such as tougher sentences for criminals.

“Thanks to this initiative today and the anti-fraud tools that were made available by the health care law, we are working to stamp out these crimes and abuse in our healthcare system,” she said in a statement.

“This partnership puts criminals on notice that we will find them and stop them before they steal healthcare dollars.”

Fraud in Medicare costs about $60 billion annually, according to estimates.