Case Management

News: Public, private groups form partnership to prevent healthcare fraud

Case Management Weekly, September 26, 2012

The federal and state governments, private health insurers, and healthcare anti-fraud groups created a partnership to prevent healthcare fraud, the U.S. Department of Health and Human Services announced recently. 

As part of the voluntary, collaborative arrangement, parties share information and best practices to detect and prevent fraudulent healthcare billing, HHS said in a press release. Its goal is to reveal and halt scams that affect public and private payers. 

The group’s goals include: 
  • Imposing tougher sentences on individuals convicted of healthcare fraud.
  • Enhanced screening of Medicare and Medicaid providers and suppliers
  • Suspending payments to providers and suppliers engaged in suspected fraudulent activity

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