Investigation ToolBox

Investigation Toolbox

The sharing of information regarding emerging fraud schemes and suspected fraudulent providers between private plans and our government liaison partners or government agencies is a top priority for NHCAA. In order to maintain its position as the number one resource for anti-fraud initiatives, NHCAA consistently reviews and enhances its suite of fraud fighting tools to increase member benefits.

SIRIS®

SIRIS® is a searchable database that consists of three data sets: one devoted to provider cases; another for health care fraud schemes; and a third that administers Requests for Investigation Assistance (RIAs) from our law enforcement partners.

Request for Investigation Assistance

RIA provides our Government Liaison agencies the ability to reach scores of private health insurers in one simple step for assistance in their health care fraud investigations.


Information-Sharing Conference Calls

NHCAA offers Information-Sharing Conference Calls on a monthly basis via a secure platform for our Member Organizations and Government Liaisons.

Case Discussion Roundtable Meetings

The sharing of case information is one of the cornerstones of NHCAA. Case Discussion Roundtable Meetings provide an opportunity for both our private and public sector members.

Fraud Briefs

NHCAA Fraud Briefs are summaries that describe a scheme related to a specific health care service. These summaries can also be used when executive management needs a better understanding of the issue.

The Sentinel

The Sentinel is a monthly newsletter that provides members with Anti-Fraud Initiatives’ updates on information-sharing opportunities and resources.

Inside SIRIS®

Inside SIRIS® provides monthly SIRIS® updates specifically designed as a resource for our Member Organizations and Government Liaisons (GLs) to increase their fraud fighting success.

The Compass

The Compass is a quarterly health care fraud report. It contains intelligence gathered from NHCAA’s Government Liaisons and Member Organization’s

Annual Fraud Trends Report

NHCAA’s Annual Fraud Trends are annual electronic reports highlighting fraud trends identified by NHCAA members. These reports include statistical information and top records by provider types from our Special Investigation Resource and Intelligence System (SIRIS®) and more.

U.S. AG’s Health Care Fraud Coordinator’s List

NHCAA is happy to support our government liaisons by actively promoting and sharing news and information about their anti-fraud efforts. To collaborate with, or participate in, a local U.S. Attorney General Health Care Fraud Workgroup, please use the coordinators list for assistance.

Member Benefits

NHCAA offers membership categories for health insurers, governmental entities, and other companies and organizations that support the NHCAA Mission, as well as individuals, who want to join us in the fight against health care fraud.

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