[authors: Maria E. Gonzalez Knavel, Lisa M. Noller, R. Michael Scarano Jr., Judith A. Waltz, Torrey K. Young]
On July 26, 2012, the U.S. Department of Health and Human Services (HHS) and the U.S. Attorney General’s Office announced that the federal government is creating a partnership with private payers and other state and private entities to attack health care fraud. Twenty-one organizations and agencies, including HHS, CMS, DOJ, FBI, Blue Cross and Blue Shield Association, Humana, and Wellpoint, have joined the partnership.1

Partnership members have agreed to the unprecedented step of proactive, pre-case information-sharing about specific schemes, billing codes, and “hot” fraud locations. According to the Coalition Against Insurance Fraud, one of the founding partnership members, participants “will share case leads, evidence, data, and other vital information” to try to prevent fraud and to facilitate False Claims Act lawsuits and criminal prosecutions.2 (The partners also have committed to sharing only “scrubbed” data, to protect patient privacy.) Specific future goals of the partnership include preventing providers from billing two different insurers for the same patient care and predicting health care fraud schemes. The partnership’s working groups are already meeting to structure a work plan, and its board, data analysis committee, and information-sharing committee will meet in September 2012.