The conference theme
The real cost of fraud and corruption in healthcare: How to reduce it?
Despite the different healthcare systems operating throughout the European Union, healthcare fraud and corruption occurs in all systems. Recent reports suggest that estimated losses to healthcare fraud amount to around 5.59% of healthcare budgets[1], or approximately 56 billion Euros across the European Union every year.
It is high time to tackle these losses at all levels and in every country, as every cent lost to fraud and corruption drains vital resources from our healthcare systems and undermines their capacity to provide essential treatment.
In addition to fraud, additional healthcare expenditures are caused by factors such as unnecessary (and expensive) treatments, redundant tests, errors and inefficiencies[2]. Last but not least, counterfeit drugs add to the burden. Possible ways to tackle these issues will also be part of the conference programme.
Tuesday 28 September 2010
| 08:00 | Registration & Coffee | |
| 08:45 | Opening of the conference & welcome |
Paul Vincke, EHFCN President & Paul Murricane, Moderator |
| 08:55 | Welcoming address | Laurette Onkelinx, Deputy Prime Minister, Minister for Social Affairs and Public Health, Belgium |
| 9:10-9:25 | The fight against fraud, a Belgian perspective | Carl Devlies, Secretary of State for the coordination of the fight against fraud, Deputy Prime Minister and Deputy Minister of Justice, Belgium |
| 9:25-9:40 | INAMI/RIZIV and the fight against healthcare fraud | Jo De Cock – Administrator General INAMI-RIZIV, Belgium |
| 9:40-9:55 | How sickness funds cooperate to counter healthcare fraud and corruption in Belgium | Marc Justaert – President, National Intermutualistic College, Belgium |
| 9:55-10:10 | The need to cooperate in the fight against healthcare fraud and corruption in Europe | Monica Macovei MEP, European Parliament |
| 10:10-10:55 | Session 1: The extent of fraud and corruption in healthcare | |
| 10:10-10:25 | The extent of healthcare fraud, corruption and waste, a US perspective | David Nelson, Director Healthcare and Science, Thomson Reuters, USA |
| 10:25-10:40 | Measuring the extent of healthcare fraud and corruption in Europe | Mark Button, Director, Centre for Counter Fraud Studies, University of Portsmouth, UK |
| 10:40-10:55 | Fraud prevention in Germany | Dina Michels, Head of Section Fighting against Fraud and Corruption in Healthcare, KKH Allianz, Germany |
| 10:55 | Coffee break | |
| 11:20-12:30 | Session 2: Counterfeit drugs in the European Union | |
| 11:20 | How the European Union tackles the problem | Marisa Matias MEP |
| 11:30 | An industry perspective | Karl Boonen, Executive Director Healthcare Solutions and Business Support, Janssen/Cilag, Belgium |
| 11:40 | Protecting the patient | Roy Van Cauwenberghe, Senior Inspector, Federal Agency for Medicines and Health Products, Belgium |
| 11:50 | Labelling medicines: a tool to counter fraud and counterfeit drugs | Brian Thornley, Chief Operations Officer, Aegate, UK |
| 12:00 | Collaborating with customs and the police | Danny Struys, Lead Inspector GAD Team at Brussels International Airport, Belgium |
| 12:10 | Panel discussion with above speakers | |
| 12:30 | Lunch | |
| 13:45-15:05 | Session 3: Conflicts of interest | |
| 13:45 | Conflicts of interest in healthcare | Marc Bogaert, Professor Emeritus, University of Gent, Belgium |
| 13:55 | Towards a sufficient legal framework for increasing transparency for non-interventional studies of the pharmaceutical industry in Austria | Bernhard Rupp, Associate Professor, University of Applied Sciences Krems, Austria |
| 14:05 | Compliance and integrity in the pharmaceutical industry | Roeland Van Aelst, Vice President Health Care Compliance EMEA & Canada, Johnson & Johnson Office of Health Care Compliance and Privacy |
| 14:15 | The global impact of conflicts of interests in medicine and public health- the swine flu case | Angela Spelsberg, Physican and Epidemiologist, Chair of the TI Working Group on Health, Transparency International, Germany |
| 14:25 | Integrity and the healthcare provider perspective | Dragana Jovanovic, Professor of Internal Medicine, Pneumology and Thoracic Oncology and Coordinator, Doctors against corruption, Serbia |
| 14.35 | Panel discussion with above speakers | |
| 15:05-15:30 | Coffee Break | |
| 15:30-16:45 | Session 4: Break-out sessions | |
| A – Measuring the extent | B – Practical operational aspects | |
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Frank Keller, Chair Head of Department for the fight against misconduct in healthcare TK Germany, Chairman |
Bernard Hepp, Chair; Medical General Director, INAMI-RIZIV, and Head of the Belgian Federal Service for Medical Control and Evaluation, Belgium |
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The use of data mining and intelligence sharing in the development of an anti-fraud strategy; Simon Peck, Head of Investigations and Medical Advice at AXA PPP Healthcare and chair of Health Insurance Counter-Fraud Group (HICFG); Ray Collins, Former Head of Fraud and AML at PruHealth and PruProtect |
Standard definition and measurement of RoI Jim Gee, Director of Counter Fraud Services, MacIntyre Hudson, UK |
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| Using Predictive Analytics to Automate Fraud Detection; Julie Malida, Principal for HealthCare Fraud, SAS Institute | Legal standards and survey representativeness to extrapolate investigation results; Freddy Falez, Professor, ULB and Analyst Medical Advisor UNMS, Belgium | |
| 16:45-17:15 | EHFCN 2nd award - Presentation | |
| 17:15-17:30 | Close of 1st day | |
| 18:30 | Transfer to reception & dinner | |
| 19:00 | Reception & Dinner | |
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Wednesday 29 September 2010
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| 8.00-8.50 |
Breakfast meeting with Paul Vincke, President EHFCN and Julie Malida, Principal for HealthCare Fraud at SAS Institute. Topics of discussion include:
In order to keep this meeting as a place of open discussion, it will be limited to 12 participants: please register in time (first come first served basis) by sending a email with “breakfast meeting” in subject, stating name, organisation and a contact phone or email to conference@ehfcn.org
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| 9:00 | Welcome & Opening of 2nd day | |
| 9:10-10:50 | Session 5: Best Practices from member countries | |
| 9:10-9:30 | Risk measurement: pilot methodology at CFS | Stephen Yeung, Statistician, NHS Scotland CFS |
| 9:30-9:50 | Risk measurement: Measuring the extent of hf&c based on survey, register and control data | Stig E. Omre; Economist, Planning & Analysis Department, Norwegian Health Economics Administration (HELFO) |
| 9:50-10:10 | Detection: The use of peer review as component of a counter fraud strategy in publicly funded primary dental care: a case study of the Republic of Ireland 2006-2009. | Liam Lynch, Oral Health Services Research Centre, University College Cork, Rep of Ireland |
| 10:10-10:30 | Investigation: Cooperation with police | Marcel De Filiquier, Honorary Controller General at National Police and Deputy Director of Litigation Control and the repression of fraud, CNAMTS, France |
| 10:30-10:50 | Sanctions: Sanctions applicable in Belgium | Stefaan Callens, Founder of Callens Law Firm, Belgium |
| 10:50-11:15 | COFFEE BREAK | |
| 11:15-12:10 | Panel Discussion: The EU Directive on patient mobility and cross-border fraud | |
| 11.15 | The EU Directive on patient mobility: are there increased risks for cross-border fraud? | Rita Baeten, Senior Policy Analyst, European Social Observatory, Belgium |
| 11.30 | Land Borders – a Potential Gateway to Health Care Fraud? A current Northern Ireland Perspective | Neville Jones, Deputy Director of Counter Fraud and Probity Services, Health and Social Care Business Services Organisation, Northern Ireland, UK |
| 11.45 | Findings from the EHFCN Cross-Border Fraud Working Group & Discussion | Jef De Gruyter, EHFCN Executive Committee member, Chair CBF Working Group |
| Session 6: International cooperation in healthcare and social security: Paving the future towards eliminating healthcare fraud & corruption | ||
| 12:15 | China's social insurance legislation and the efforts to reduce fraud | Jiye Hu, Associate Professor, China University of Political Science and Law; China |
| 12:30 | European regulations related to countering in-kind benefits fraud and their implementation by social securities | Gillian More, DG EMPL - Unit E3 (Free Movement of Workers and Coordination of Social Security Systems), European Commission |
| 12:45 | The need for cooperation in countering social security fraud and error | Didier Verbeke, Counsellor General, Federal Public Service (FPS) Social Security, Belgium |
| 13:00 | Conclusions | |
| 13:15 | Close of conference + LUNCH | |
[1] Gee J, Button M, Brooks G. The financial cost of fraud University of Portsmouth – MacIntyre Hudson, 2009
[2] Where can $700 billion in waste be cut annually from the US Healthcare system? Thomson Reuters, 2009