Fraud, Waste and Abuse: What today’s leading organizations are recommending to transform unnecessary costs into a strategic opportunity

It’s an unfortunate truth: Fraud, waste and abuse (FWA) runs rampant across the healthcare marketplace. According to several industry sources, in 2011 more than $98 billion was lost due to Medicare and Medicaid fraud, waste and abuse alone and tens of billions of dollars more at commercial health plans. In fact, estimates suggest between three and ten percent of all U.S. dollars spent on healthcare services are attributed to this issue. With healthcare costs continuing to hamstring the nation’s economy it’s an epidemic that insurers and providers simply must get under control.

The Affordable Care Act (ACA) most certainly recognizes the importance of addressing the nation’s fraud, waste and abuse problem. In fact, this new healthcare legislation dedicates $350 million to be spent during the next 10 years to help fight the issue. In addition, the ACA includes several new rules and penalties designed to help reduce the amount of healthcare fraud happening each year. But it’s not enough. Read more

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