Members of the U.S. House voted Monday to pass a bill that could help private health insurers fight fraudulent claims.
The bill is H.R. 525, the “Strengthening the Health Care Fraud Prevention Task Force Act of 2019″ bill.
The bill calls for the secretary of the U.S. Department of Health and Human Services (HHS) to set up a public-private anti-fraud partnership program.
Public-Private Partnership Program Details
The new partnership program would be open to federal health programs , state health programs, law enforcement agencies, private organizations that fight health care fraud, private health plans, and other entities.
The partnership program would create data-sharing and data-use agreements that would let the member organizations share confidential billing data.
The HHS secretary would then hire a “trusted third party” to help the member organizations share billing data.
The contractor would warn the member organizations about apparent vulnerabilities, report “specific cases of potential unlawful conduct” to law enforcement agencies, and look for possible signs of fraud, waste and abuse.
The HHS secretary would prepare a report on the partnership program’s activities every two years.
The partnership program contractor would also prepare a separate analysis looking at any signs of worrisome billing patterns at substance use disorder treatment providers, according to the bill text.