The National Health Care Anti-Fraud Association has released a white paper, "Combating Health Care Fraud in a Post-Reform World: Seven Guiding Principles for Policymakers", which has been published in light of recent healthcare reform and a new governmental focus on preventing fraud, according to an association news release.
In the white paper, NHCAA publishes seven recommendations for regulators and policy makers:
1. The sharing of anti-fraud information between private insurers and government programs should be encouraged and enhanced.
2. Data consolidation and real time data analysis must be at the forefront of healthcare fraud detection and prevention.
3. Pre-payment reviews and audits should be increased and strengthened.
4. Public and private health plans should be allowed to protect their enrollees by barring or expelling providers suspected of perpetrating healthcare fraud.
5. Healthcare providers participating in fraud should be sanctioned by their respective state licensing boards.
6. Healthcare provider identifier numbers should be made more secure.
7. Investment in innovative healthcare fraud prevention, detection and investigation efforts and programs should be encouraged.
Read the NHCAA news release about "Combating Health Care Fraud in a Post-Reform World: Seven Guiding Principles for Policymakers."
Read other coverage about healthcare fraud:
- CMS to Distribute $9M in Grants to Strengthen Senior Medicare Patrol Programs
- Oklahoma Senator Introduces Anti-Fraud Legislations
- CMS Required to Implement Anti-Fraud Software with "Predictive Modeling" By Next Year
In the white paper, NHCAA publishes seven recommendations for regulators and policy makers:
1. The sharing of anti-fraud information between private insurers and government programs should be encouraged and enhanced.
2. Data consolidation and real time data analysis must be at the forefront of healthcare fraud detection and prevention.
3. Pre-payment reviews and audits should be increased and strengthened.
4. Public and private health plans should be allowed to protect their enrollees by barring or expelling providers suspected of perpetrating healthcare fraud.
5. Healthcare providers participating in fraud should be sanctioned by their respective state licensing boards.
6. Healthcare provider identifier numbers should be made more secure.
7. Investment in innovative healthcare fraud prevention, detection and investigation efforts and programs should be encouraged.
Read the NHCAA news release about "Combating Health Care Fraud in a Post-Reform World: Seven Guiding Principles for Policymakers."
Read other coverage about healthcare fraud:
- CMS to Distribute $9M in Grants to Strengthen Senior Medicare Patrol Programs
- Oklahoma Senator Introduces Anti-Fraud Legislations
- CMS Required to Implement Anti-Fraud Software with "Predictive Modeling" By Next Year