The Coalition Against Insurance Fraud, the National Health Care Anti-Fraud Association and the National Insurance Crime Bureau are partnering together to form the Consortium to Combat Medical Fraud.

Participants include these three organizations, their member insurance companies, state insurance fraud bureaus, and representatives from the Federal Bureau of Investigation.

The Consortium to Combat Medical Fraud states that its primary objective is to move toward creating a national agenda to combat medical fraud for public and private benefit by unleashing their members’ collective resources. Specific actions include:

Sharing information across industry and among stakeholders;

Leveraging industry best practices;

Influencing the public policy debate and shaping the future agenda;

Optimizing and aligning objectives of various associations.

According the newly formed consortium, fraud committed by medical providers in the United States continues to total tens of billions of dollars each year. Perpetrators range from organized criminal enterprises that stage auto accidents, surgical centers that perform unnecessary operations, and family physicians that occasionally bill for treatment not provided. Fraud is a continuing problem in virtually all segments of medicine, including diagnostic centers, durable medical equipment supplies, pharmacies, and medical transport companies.

There has been little coordination among the various segments to share intelligence, strategies, and training involving fraud by medical providers. The goal of the Consortium to Combat Medical Fraud is to close these gaps.

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