In new effort to tackle health care fraud, government and insurers to scrutinize claims data-livejournal-blogger

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WASHINGTON — The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses.

Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals on notice that we will find them and stop them,” while Attorney General Eric Holder called it “a critical step forward” against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies.

Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud. The agreement is also unusual because it brings the Obama administration and longtime foes in the insurance industry together to tackle a common problem.

While carrying out the requirements of President Barack Obama’s health care overhaul law, insurers are also lobbying to roll back some of its provisions, such as new taxes on the industry and cuts to private plans offered through

Medicare. Obama continues to rail against industry “abuses.” Fraud is estimated to cost Medicare about $60 billion a year, and the Obama administration has beefed up the government’s efforts to stop it, bringing in record settlements with drug companies for marketing violations as well as using new powers in the health care law to pursue low-level fraudsters with greater zeal.