A Consortium to Combat Medical Fraud has been formed that will data-mine healthcare claims and compare them with claims submitted to other types of insurance such as property and casualty carriers in an effort to curb insurance fraud.
Members of the consortium are the Coalition Against Insurance Fraud, National Health Care Anti-Fraud Association and National Insurance Crime Bureau along with the Justice Department and FBI.
The new consortium aims to create a more open and collaborative environment between different segments of the insurance industry to heighten the detection and prevention of healthcare fraud, according to a news release Tuesday. Specifically, the first study by the new group will focus on state medical boards to evaluate how well they are disciplining licensees who commit fraud.
Another area of activity will be the cross-matching of claims across different types of insurance and other types of data used by property/casualty and health insurance companies to better detect fraudulent schemes as well as collaborating to build stronger cases against criminals, the statement said.