Mary Ellen Stahlman
Fraud, abuse, and waste seem to be ubiquitous weaknesses in our health care system. Although a relatively small proportion of health care providers, patients, and insurers engage in these practices, all Americans pay the price in terms of higher spending and often poor quality care. This session examined the most effective tools for prevention and early detection of fraud, abuse, and waste, particularly in relation to Medicare. The session also probed whether Medicare’s arsenal of anti-fraud tools is sufficient, considered whether policymakers’ expectations for program savings from anti-fraud activities are realistic, and explored impediments to the adoption of promising strategies.
Kimberly Brandt, Director, Program Integrity Group, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services; Edward J. Litchko, Senior Director, Corporate & Financial Investigations Department, Independence Blue Cross; Cesar Arias, Private Investigator, Stonecold Investigations, LLC