EXCLUSIVE: Elected Officials, Companies Launch New Initiative To Reduce Healthcare Fraud

Top companies and financial officers across the nation launched a new scorecard in an effort for better transparency and fraud mitigation in healthcare spending, the Daily Caller News Foundation has first learned.

The “Corporate Health Plan Fiduciary Scorecard” comes following a partnership between the Health Transformation Alliance (HTA) — a cooperative of more than 85 U.S. companies including J.P. Morgan Chase and the Coca-Cola company — and the State Financial Officers Foundation (SFOF) which is comprised of 42 elected state treasurers, auditors, comptrollers, and chief financial officers.

“There’s an opportunity here to work on behalf of the American people, so over a series of different conversations we worked together not to shame any businesses but to create an opportunity for businesses to do the best they can to reduce the cost of health insurance,” SFOF CEO Dr. OJ Oleka told the DCNF. “If individuals are able to see how much they’re paying for health insurance, then they can actually go out there and compete in the marketplace and drive down costs.”

The scorecard consists of 30 different questions in three different categories to assess a company’s fiduciary practices, oversight and leadership. Companies answer “Yes or No” and provide comments to better assess where they are in terms of healthcare transparency and accountability.

Some specific questions also assess whether a company has safeguards on the use of artificial intelligence, whether it identifies hidden “dark money” health plan revenue streams or makes a habit of conducting regular independent audits of these money streams.

“We want to make sure we can gather as much data as possible and understand how businesses are thinking about these things,” Oleka told the DCNF.

The scorecard presents an opportunity for this information to be made public and also mitigate the potential for fraud and distrust amongst businesses.

“We take the old mantra: trust but verify, and this scorecard is an opportunity for verification,” Oleka said. “If a company says they’re not committing fraud, show us all the information and the details. That’s the request here. If a company is willing to be more forthright in the information and the details, then you’re less likely to suspect them of fraud.”

Healthcare insurance fraud costs taxpayers tens of billions of dollars each year, according to reports from the FBI. Because of hidden fees and lack of transparency amongst insurance companies, companies and individuals can quietly steal millions of dollars worth of financial assets.