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NHCAA Releases 2018 Year-in-Review

Published on 2/15/2018 by “NHCAA”

NHCAA distributed the Association's 2018 Year-in-Review highlighting the past year's successes and accomplishments, confirming once again that the Association provides our members, partners, and the industry with a range of effective resources to improve and strengthen the fight against health care fraud.

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Press Release: Roger I. Purnell Elected NHCAA Board Chair

Published on 11/20/2017 by “NHCAA”

The National Health Care Anti-Fraud Association (NHCAA) announced that Roger I. Purnell, AHFI, CFE, Director of the Special Investigations Unit (SIU) at BlueCross BlueShield of North Carolina (BCBSNC) has been elected as the 2019 Chair of the NHCAA Board of Directors.

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2018 Award Winners

Published on 11/20/2017 by “NHCAA”

NHCAA would like to congratulate the winners of the 2018 NHCAA Awards Program: Investigation of the Year, Medical Directors, John Morris Volunteer Service and SIRIS Investigation of the Year.

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The ROI of Fighting Health Care Fraud: The Impact of Methodological Variability

Published on 6/28/2018 by “NHCAA”

NHCAA has published a new white paper that examines the scope of responsibility of health insurer special investigations units and how they calculate return on investment within their organizations. NHCAA’s biennial Anti-Fraud Management Survey reports on SIU outcomes, which have historically been combined to calculate SIU return on investment. This new paper provides insight about the challenges in measuring SIU ROI while demonstrating the value SIUs bring to their organizations.

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NHCAA Comments on Proposed Changes to MLR Under Medicare Parts C & D

Published on 1/17/2018 by “NHCAA”

The Centers for Medicare and Medicaid Services (CMS) has proposed significant changes to how medical loss ratio is calculated and reported for Medicare Advantage and Part D plans. If made final, the rule would expand the definition of Quality Improvement Activities (QIA) to include fraud reduction activities, including fraud prevention, fraud detection, and fraud recovery. NHCAA submitted a letter of support.

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