In North America alone, it is estimated that 2 to10% of all healthcare dollars are lost to fraud. Canada's life and health insurers have made and continue to make significant investments in technology, skilled staff, and awareness initiatives with their clients to mitigate healthcare fraud. However, the industry recognizes that reducing healthcare fraud is a team effort and ultimately, the best means to mitigate fraud and abuse is to work with all stakeholders to prevent it from occurring. In that regard, the industry works collaboratively with healthcare professions, clients (plan sponsors), and law enforcement to assist in providing education to minimize the impact of fraud and abuse on benefit plans. The industry also plays an important role in supporting Fraud Prevention Month (FPM) with active campaigns during the month of March.
Healthcare fraud awareness
Many of Canadian Life and Health Insurance Association’s (CLHIA) member companies plan awareness events designed to provide consumers with education and awareness on the impact of healthcare fraud and abuse. These resources include tips on how they can protect themselves and who to contact to report suspected healthcare fraud.
How CLHIA is doing its part
CLHIA is also doing its part to create public awareness and assist members in their efforts to mitigate fraud including advertisements running during the month of March in BC Business, the Globe and Mail (FPM supplement) and in On the GO Magazine. You can also catch video clips on display screens in the PATH—downtown Toronto’s underground pedestrian walkway—and in Gateway newsstands.
Canadian life and health insurers provide important supplementary health coverage to approximately 27 million Canadians and pay over $30 billion annually for healthcare services delivered to Canadians through benefit plans that are largely purchased by employers. They provide valuable support to employees so that they can remain healthy, active, and productive both at work and at home. However, sustainability of plans has become an increasing concern for employers over the last several years due to increasing cost pressures (high cost drugs, etc). Fraud and abuse of benefit plans add to these cost pressures, which over time may create a need for changes and impact everyone covered by that plan.
We all need to work together to minimize abuse of benefit plans. Here are some tips on how you can help:
Fraud: Recognize it, Reject it, Report it!
Written by: Canadian Life and Health Insurance Association.