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July 27, 2012

New anti-healthcare fraud effort unveiled

U.S. Attorney General Eric Holder and Human Service Secretary Kathleen Sebelius deliver remarks after a meeting announcing a public-private partnership to prevent health care fraud. (UPI/Kevin Dietsch)

WASHINGTON (UPI) -- The Obama administration Thursday unveiled a public-private partnership to combat healthcare fraud and block scams that drain U.S. taxpayer dollars.

"In the past, too often we in the government followed the pay-and-chase model: paying claims first, and only later trying to track down the ones we discovered to be fraudulent. The money was already out the door. Now we're taking away the crooks' head start," Health and Human Services Secretary Kathleen Sebelius said in announcing the effort.

Attorney General Eric Holder said the partnership will help law enforcement officials employ "cutting edge technology ... more effectively and identify suspicious activity and safeguard precious taxpayer resources."

The partnership is designed to share information and best practices to improve detection and prevent payment of fraudulent billings.

"This partnership is a critical step forward in strengthening our nation's fight against healthcare fraud," Holder said, saying the administration already has recovered "nearly $4.1 billion in cases involving fraud against federal healthcare programs" and government anti-fraud efforts "return on average $7 to the U.S. Treasury, to the Medicare trust fund and others" for every $1 spent.

Among those participating in the effort are the nation's largest health insurers.

Karen Ignani, president and chief executive officer of America's Health Insurance Plans, called the plan a "crucial step forward."

"Working together in our view will allow us to do four things: share information, identify fraud early, weed it out more quickly, protect patients from being at risk for inappropriate, substandard or wrong care," Ignani said.

"The cost of fraud is far more substantial than the matter of claims that should not be paid. It can cause real harm to patients who have been intentionally exposed to radiation, invasive surgeries and medications they don't need. Or suffered the lasting consequences ... of receiving fraudulent diagnoses that either they never find out about or follow them through the rest of their lives in their medical records."

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