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VA, HHS Announce Healthcare Fraud Prevention Partnership

The federal agencies have agreed to participate to identify and prevent fraud in public payer programs.

Federal payer agencies agreed to collaboratively identify and prevent fraud.

Source: Thinkstock

By Thomas Beaton

- The Department of Veterans Affairs (VA), HHS, and CMS agreed to participate in a healthcare fraud prevention partnership that leverages data sharing to identify fraud and abuse within healthcare programs they collectively oversee.

The organizations announced in a press release that the VA plans to leverage CMS improvements in data analytics to enhance fraud detection and prevention efforts. CMS previously demonstrated success in fraud prevention analytics based on the results of the federal agency’s Center of Program Integrity implemented in 2010.

CMS estimated that the center helped save Medicare $17 billion during 2015 as a result of fraud prevention activities.

VA Secretary Dr. David J. Shulkin believes that the arrangement is a promising next step in protecting his federal agency from healthcare fraud.

“The VA-HHS alliance represents the latest example of VA’s commitment to find partners to assist with identifying new and innovative ways to seek out fraud, waste and abuse and ensure every tax dollar given to VA supports Veterans,” Shulkin said.

“This effort marks another step toward achieving reform in the VA by collaborating with our federal partners to improve VA’s ability to investigate fraud and wrongdoing in VA programs.”

Previously, VA invited industry leaders last November to educate its leaders on the latest commercial technologies and techniques to enhance fraud detection. VA will re-invite industry experts to demonstrate the capabilities of fraud detection technologies in preventing fraud and recovering improper payments.

CMS Administrator Seema Verma added that her agency must do everything to support and protect VA from healthcare fraud vulnerabilities.

“We have a special obligation to keep America’s promise to those who have served our country and ensure that Veterans receive high-quality and accessible health care,” Verma said.

“CMS is sharing lessons learned and expertise to support VA to identify waste and fraud and eliminate these abuses of the public trust. Using state-of-the-art data analytics, CMS is partnering with VA to better detect and prevent wrongdoing in its programs.”


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