STARS®Solutions Suite - General Dynamics Information Technology

Fraud, Waste and Abuse Protection
Other estimates by government and law
enforcement agencies 2 place the loss due to
healthcare fraud as high as10 percent of our
nation’s annual healthcare expenditure–or a
staggering $226 billion–each year. And they
anticipate the cost of healthcare will only
continue to rise, which means the price tag
associated with healthcare fraud, waste and
abuse (FWA) is expected to rise too.
No commercial or government health payer
organization can afford to write off this much.
Yet that happens when fraudulent claims are
unintentionally paid. Left unchecked, the enormous
cost of healthcare FWA threatens both
the quality of healthcare and access to care
for millions of Americans.
The General Dynamics IT
Advantage
General Dynamics Information Technology
has a broad and deep understanding of
healthcare billing, claims processing and
healthcare FWA. We have a proven track
record of quality-driven solutions, successful
implementations and service quality. When you
couple that with our well-earned reputation for
managing complex data extraction and integration
projects, you have a dynamic convergence
of abilities that can make a big difference in the
return on your healthcare information technology
(IT) investments and the quality of your
decision-making in an anti-fraud program.
At General Dynamics IT, we are experts in
collecting, analyzing and reporting data related
to FWA. Our work is backed by an organization
with more than 30 years of experience
aggregating and analyzing data - one with
more than 50 large-scale data warehouse
deployments, more than 2.5 billion claims
stored and analyzed annually, and more than
300 million covered lives analyzed annually.
Major government programs and 70 of the top
200 health plans use our healthcare informatics
solutions. You can count on keen insights,
rigorous analysis, smooth implementations and
superior service.
FAST FRAUD FACTS
• The U.S. spends more than $2 trillion
on healthcare annually. At least 3
percent of that spending–or $68
billion–is lost to FWA each year.
(National Health Care Anti-fraud
Association, 2009)
• In 2011, the Health Care Fraud
Prevention and Enforcement Action
Team (HEAT), comprised of the
Department of Justice and the U.S.
Department of Health and Human
Services, recovered more than $4
billion due to the departments’
anti-fraud activities. (HHS News
Release, April 4, 2012) 3
1. National Health Care Anti-fraud Association, 2009. http://www.nhcaa.org
2. Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Expenditure Projections 2007-2017.
Federal Bureau of Investigation, Financial Crimes Report to the Public, Fiscal Year 2007.
http://www.cms.hhs.gov/NationalHealthExpendData/Downloads/proj2007.pdf, http://www.fbi.gov/publications/financial/fcs_report2007/financial_crime_2007.htm
3. http://www.hhs.gov/news/press/2012pres/04/20120404a.html