Healthcare insurance fraud represents a growing threat, as a weakened economy creates incentives for criminals. Larry Jacobson describes a technological approach to fighting back.
News about healthcare fraud scams brought to heel by the police – such as the prison sentence awarded in February to an NHS manager who created a fictitious care home – send a feel-good message about the industry’s watchfulness. Sadly, these are small battles in a war that is taking a huge toll on healthcare providers and insurers. According to the Healthcare Insurance Counter Fraud Group, private medical insurers lose £280m to £420m per year to fraud. The Home Office’s National Fraud Authority puts the annual NHS patient fraud losses at £165m. Some reports claim these figures a...
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