Antifraud associations representing both the property-casualty and health insurance sectors will pool their resources to increase detection and prevention of health care fraud, they announced today.

The organizations are calling this joint effort the Consortium to Combat Medical Fraud.

At a press conference, The Coalition Against Insurance Fraud, the National Insurance Crime Bureau (NICB) and the National Health Care Anti-Fraud Association (NHCAA) said they will share information, organize joint education initiatives and work collaboratively with law enforcement to fight fraud that often crosses over between the p-c and health insurance sectors.

A statement released by the associations noted that unscrupulous medical providers routinely engage in schemes such as fraudulently billing for services that are not provided and "defraud all segments of the insurance industry that provide compensation for illness and injury.

Fake billing and treatment of nonexistent injuries was said to impact health insurance, auto insurance carriers, workers' compensation and disability insurance.

Dennis Jay, executive director of the Coalition Against Insurance Fraud, noted that medical providers who fraudulently bill insurance companies are also more likely to perform needless surgeries and procedures on patients, and he explained that a reduction in this type of misconduct is an additional benefit of fighting medical fraud.

The associations said that greater coordination is needed to combat these schemes. Specifically, the new consortium will hold education sessions that will help insurance investigators on both the health and p-c sides learn each other's fraud-fighting techniques and strategies.

Additionally, the associations will work with each other to cross-match claims and data to uncover fraud schemes that cross over from one sector to another.

Gary Healy, director of operations for the Mid-Atlantic NICB, said the NICB has discovered that many fraud perpetrators who defraud p-c insurers use the same schemes to defraud health insurers as well.

He said that when NICB conducts an investigation, it is sometimes only able to gather half of the information because much of the fraud perpetrators' activity is on the health insurance side.

By sharing information between p-c and health investigators, he said, fraud fighters will be able to bring more complete and effective cases against those engaging in insurance fraud.

Mr. Jay said this collaborative initiative is timely, as fraud rings tend to be more active when the economy experiences a downturn.

He also said health insurance fraud represents the greatest slice of the pie with respect to insurance fraud, and he added that medical fraud affects all lines of insurance.

Louis Saccoccio, executive director of NHCAA, said in a statement, "Never before have different parts of the insurance system cross-pollinated to seek new ways to prevent fraud. This approach will break down barriers and increase awareness across insurance lines so that we share information and coordinate our approach more systematically."

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