Dear reader
Welcome to the March-April issue of the EHFCN Newsletter. Please let us inform you on our main activities for the upcoming months.
Enjoy reading!
Lead Story
The ‘bottom' ten healthcare frauds of the 2000s
Over the last decade healthcare fraud has rarely been out of the headlines, with 70,610 reports of fraud in the global media. Over the last year especially healthcare fraud has made headlines in the United States and Europe with the focus increasingly on its cost.
This is estimated average 5.59% of healthcare expenditure or, globally, £160 / €180 / $260 billion each year, enough to:
- provide clean, safe water around the globe
- bring malaria under control in Africa
- provide the Diptheria, Tetanus and Pertussis vaccine to all 23.5 million children under one years old who are currently not immunized (2.5 million die each year from diseases preventable by vaccines)
AND
- quadruple the budget of the World Health Organisation and UNICEF (the United Nations Children's Fund)
…with more than £100 billion left over – enough to build more than 1,000 new hospitals at developed world prices.
Choosing the worst healthcare frauds of the last decade – or the ‘bottom ten' – is a tough task. It involves balancing the value of the fraud and deviousness, and the damage done to human life. Sometimes healthcare fraud can be enormous and sometimes strange, but it is nearly always wicked. As a result, people wait longer for treatment in pain, get worse quality care and sometimes die unnecessarily.
Jim Gee, Director of Counter Fraud services at MacIntyre Hudson LLP, chooses his ‘worst healthcare frauds of the decade' below:
Top 10 worst cases of fraud - part 1
Top 10 worst cases of fraud - part 2
Fraud is possible in any healthcare system. This highlights some examples from the last decade, but more generally, fraud is a significant financial cost to any healthcare organisation and diverts important resources from providing patient care. ‘The Financial Cost of Healthcare Fraud Report', published in January 2010, is the most in-depth report ever undertaken about the real cost of healthcare fraud. It shows average losses of 5.59% across 66 exercises in 33 organisations from 6 countries which covered expenditure totalling over £300 billion.
The good news is that it has been shown that these losses can be reduced by up to 40% within a year and up to 60% over a longer period.
