Public-private healthcare fraud partnerships aim at prevention

Cooperation, information sharing key parts of process

January 30, 2015

By Brian Eastwood

For decades, fighting healthcare fraud has involved a "pay-and-chase" mentality. Insurers pay criminals for fraudulent claims, prescriptions and the like and investigators chase them down, hoping to get that money back through criminal charges or the False Claims Act.

Recently, though, the focus has started to shift to prevention. Accompanying this shift has been a growth in public-private partnerships, bringing together federal and state government agencies, private insurers and professional organizations.

These partnerships work best when the entities involved are willing to cooperate and to share information. "The driving force between a lot of information-sharing and partnerships is trying to get ahead of the curve; to prevent the dollars from going out the door in the first place," Louis Saccoccio, CEO of the National Health Care Anti-Fraud Association (NHCAA), said in an exclusive interview with FierceHealthPayer: AntiFraud.


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