Programme
Fighting fraud in healthcare and social security: How to maximise resources?
This 2011 conference will mark a turn in the history of EHFCN, as for the first time the conference will not only focus on the fight against fraud in healthcare but on the fight against fraud in social security in general.
Although social security and healthcare systems are different throughout member states, fraud processes share similarities. So do the ways to combat them. Counter fraud, error and corruption strategies and methods are generically and technically speaking the same for both sectors. They can be compared and adapted to the respective circumstances. This is why we have chosen the occasion of this event to widen the scope of our conference and of our Network.
Draft programme
Thursday 6 October 2011
| 08:00 | Registration & Coffee | |||
| 09:00 | Opening of the conference & welcome |
Paul Vincke, EHFCN President / Karolina Zbytniewska, Moderator, Poland |
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09:10- 09:55 |
Opening Speeches – The role of the Central Anti-Corruption Bureau in combating criminal offences in healthcare. |
Ewa Kopacz, Minister of Health, Poland Mariusz Kujawski, Director of the Department of the Central Anticorruption Bureau, Poland |
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| 09:55-11:25 | Session 1 = Fraud in healthcare and social security in the European Union | |||
| 09:55 | Fraud in social security across the European Union | Jozef Pacolet, HIVA, Catholic University of Louvain, Belgium | ||
| 10:25 | Fraud in social security – the Polish perspective | Miroslawa Boryczka, Social Insurance Institution (ZUS), Poland | ||
| 10:45 | Identity fraud (EU) – The problem and concrete examples | David White, Department for Work and Pensions, UK | ||
| 11:05 | Fighting fraud in practice: lessons learnt in unemployment and disability insurance | Miranda Vermeulen, UWV, The Netherlands | ||
| 11:25 | Q&A | |||
| 11:40 | Coffee break | |||
| 11:55-12:55 | Session 2 = Current Network: projects and next steps | |||
| 11:55 | Good governance in health systems – the Council of Europe approach. |
Ulrich Laaser, MPH Section of International Public Health, University of Bielefeld, Germany; Council of Europe |
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| 12:10 | Informal payments in CEE countries: an intermediate report | Stanislawa Golinowska, Uniwersytet Jagiellonski Collegium Medicum, Poland | ||
| 12:25 | Fraud prevention in Germany: why is the government still amending the wording of law | Thomas Bade, Management Consultant to the healthcare and health insurance industry, Germany | ||
| 12:40 | Cross-border fraud in healthcare in the EU | Paul Vincke, EHFCN | ||
| 12:55 | Improved cooperation and share of information: the piramid system | Didier Verbeke, Federal Public Service (FPS) Social Security, Belgium | ||
| 13:15 | Lunch | |||
| 14:15-15:45 | Session 3 = Break-out sessions | |||
| A – Waste in healthcare | B – Fraud Management in Social Security | |||
| The problems of overconsumption; do medical guidelines help; the need for standardization | From deterrence and prevention to detection and investigation | |||
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Paul Garassus, European Union of Private Hospitals (UEHP) France Susanne Weinbrenner, ÄZQ, Germany Roy Poses, Brown Univ. Rhode Island, USA
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Margaret Worsfold, NHSScotland CFS Tony Ellis, IBM (ex-London Borough of Brent), UK Dariusz Śpiewak, ZUS, Poland Marek Ujejski, NHF, Poland Session moderator: Hammou Messatfa, IBM, France |
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| 15:30 | Summaries and outcomes of break-out sessions | |||
| 16:00-16:30 | Coffee Break | |||
| 16:30-19:00 | EHFCN General Assembly | |||
| 19:30 | Transfer to reception & dinner | |||
| 20:00 | Reception & Dinner | Restaurant Miód i Wino | ||
| (EHFCN 3rd award presentation) | ||||
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Friday 7 October 2011
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| 08:00-08:50 |
Breakfast meeting (*) 1- How to stop fraud before paying a claim versus the “pay and chase” approach 2- Crossing Borders – organized crime that penetrate national borders 3- Whether and how enhanced detection is a reality |
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| 09:00 |
Workshop Business Analytics | |||
| 09:00-09:20 | Introduction / welcome Workshop's objectives; EHFCN's plan 2011-2012; SAS, IACA & EHFCN collaboration. |
Paul Vincke, EHFCN President / Georg Florian Grabenweger, IACA, Austria |
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| 09:20-10:00 | Are analytics needed? Why they may facilitate the findings, predictions and prevention of Fraud, Waste and Abuse | Andrew Pease; SAS, Belgium | ||
| 10:00-10:30 |
Interactive session/Member presentation of a case in Poland |
Zbigniew Teter; Kamil Kondracki; National Health Fund, Poland |
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| 10:30-11:00 | IACA: How to improve yourself in your role as an investigator |
Georg Florian Grabenweger, IACA, Austria |
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| 11:00-11:15 | Coffee break | |||
| 11:15-12:15 |
The power of analytics: Demo of a tool to detect and prevent fraud |
Ross Kaplan, SAS, USA |
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| 12:15-13:00 |
Interactive session/Member presentations |
Gabriel Bacq, CNAMTS, France Hans Nagels, INAMI-RIZIV, Belgium |
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| 13:00-13:15 |
Conclusions & Close of event |
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(*)Limited to 12 participants; registrations on a “first come first served” basis by sending an email to conference@ehfcn.org with “breakfast meeting” in the subject line, stating name, organization and a contact phone or email.