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 | Opening Speech – The fight against fraud, an EU Perspective | Mr John Dalli, EU Commissioner for Health and Consumer Policy |
| 9:10-9:25 | Opening Speech – The fight against fraud, a Belgian perspective. | Mr 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 | Mr Jo De Cock – Administrator General INAMI-RIZIV, Belgium |
| 9:40-9:55 | How sickness funds cooperate to counter healthcare fraud and corruption in Belgium | Mr Marc Justaert – President, National Intermutualistic College, Belgium |
| 9:55-10:45 | Session 1: The extent of fraud and corruption in healthcare | |
| 9:55-10:10 | The extent of healthcare fraud, corruption and waste, a US perspective | David Nelson, Thomson Reuters, USA |
| 10:10-10:25 | Measuring the extent of healthcare fraud and corruption in Europe | Mark Button, Centre Counter Fraud Studies, University of Portsmouth, UK |
| 10:25-10:40 | Fraud prevention in Germany | Dina Michels, KKH Allianz, Germany |
| 10:45 | Coffee break | |
| 11:15-12:30 | Session 2: Counterfeit drugs in the European Union | |
| 11:15 | How the European Union tackles the problem | Antonyia Parvanova MEP |
| 11.25 | An industry perspective | Karl Boonen - Chris Verleye, Janssen/Cilag, Belgium |
| 11.35 | Protecting the patient | Roy Van Cauwenberghe, Federal Agency for Medicines and Health Products, Belgium |
| 11.45 | Collaborating with customs and the police | Danny Struys, Ministry of Finances, Customs & Excise Administration, Belgium |
| 11.55 | 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, University of Applied Sciences Krems, Austria |
| 14.05 | Compliance and integrity in the pharmaceutical industry | Dominique Laymand, Bristol-Myers Squibb |
| 14.15 | Integrity and the healthcare provider perspective | Dr Schaeffler MD and founder of "no free lunch" association, Germany |
| 14.35 | Q&A | |
| 15:05-15:30 | Coffee Break | |
| 15:30-16:45 | Session 4: Break-out sessions | |
| A – Measuring the extent | B – Practical operational aspects | |
| Frank Keller, TK Germany, Chairman | Bernard Hepp, INAMI-RIZIV Belgium, Chairman | |
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The use of data mining and intelligence sharing in the development of an anti-fraud strategy; Simon Peck/ Ray Collins; HICFG |
Standard definition and measurement of RoI Lou Saccoccio, NHCAA |
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Using Predictive Analytics to Automate Fraud Detection; Julie Malida, SAS Institute |
Military standards to extrapolate investigation results Josse Van Steenberge, University of Antwerp |
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| 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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| 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 | Dr Stephen Yeung, NHSScotland CFS |
| 9.30-9.50 | Risk measurement: Measuring the extent of hf&c based on survey, register and control data | Stig E. Omre; 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. | Dr Liam Lynch, Oral Health Services Research Centre, University College Cork, Rep of Ireland |
| 10.10-10.30 | Investigation: Cooperation with police | Marcel de Fliliquier, CNAMTS, France |
| 10.30-10.50 | Sanctions: Four types of sanctions in Belgium | Eveline Ankaert, Institute for Social Law, Catholic University of Leuven, Belgium (tbc) |
| 10:50-11.20 | COFFEE BREAK | |
| 11:20-12:45 | Session 6: International cooperation: Paving the future towards eliminating healthcare fraud & corruption | |
| 11.20 | European regulations related to in-kind benefits and their implementation by social securities | Didier Verbeke, Advisor General, Federal Public Service (FPS) Social Security, Belgium |
| 11.35 | International cooperation: examples of bilateral agreements in the Netherlands | Cynthia Coumans, UWV, the Netherlands (tbc) |
| 11.50 | Land Borders – a Potential Gateway to Health Care Fraud? A current Northern Ireland Perspective | Neville Jones, Health and Social Care Business Services Organisation, Northern Ireland, UK |
| 12.05 | International cooperation in the fight against cross-border fraud | Jef De Gruyter, EHFCN Executive Committee member |
| 12.20 | International experience of cooperation | International Association of Medical Regulating Authorities, Belgium (tbc) |
| 12.35 | Testimonial | Speaker (tbc) |
| 12.45 | Paving the future towards eliminating healthcare fraud & corruption | Ms Laurette Onkelinx, Vice Prime Minister, Minister for Social Affairs and Public Health |
| 13.00 | Conclusions | |
| 13:10 | 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