2010 EHFCN Awards to be conferred to NHSScotland Counter Fraud Services and to Dr Bernard Hepp, Medical Director General of the RIZIV-INAMI (Belgium)
28.9.2010
The European Healthcare Fraud and Corruption Network (EHFCN) announced that their 2010 Excellence Awards will be conferred to the National Health Service Scotland (NHSS) Counter Fraud Services (CFS), and to Dr Bernard Hepp, Head of the Medical Evaluation and Inspection Department of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV), at the Network’s Annual Conference in Brussels on 28-29 September 2010.
Paul Vincke, President of EHFCN, said:
“The Awards aim to attract interest and to stimulate best practices in counter fraud and counter corruption activities in healthcare throughout Europe. This is why the EHFCN Award Comittee has decided to grant two awards recognising the particular action or initiative of one organisation and one individual respectively.
“Since CFS was set up, the CFS team has proven to be successful in every counter fraud step. Their clever and professional use of a combination of media, intelligence and IT has led to millions of Euros saved for better patient care. Similarly, the global and integrated system against fraud implemented by Dr Bernard Hepp has contributed to the optimal use of Belgian healthcare resources. By drawing up two laws, enhancing healthcare providers accountability, modernising medical inspection, and making it operational, the fight against healthcare fraud has taken a huge step forward.”
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The all-embracing integrated system against fraud in the Belgian Healthcare and Benefits Insurance implemented by Dr Bernard Hepp was developed according to a three pillar strategy of Information, Control and Evaluation. It was based on the facts that the continuous assessment of healthcare providers’ behaviour has a strong preventative effect and that investigations should be run by healthcare professionals and carried out in a juridical way. A unique and specific legal system of sanction procedures, attached to the INAMI-RIZIV, reinforces the new system which allows “minor” cases to be closed with a recovery, a warning and possibly a fine, and “bigger” cases to be dealt with by the Head of the Medical Evaluation and Inspection Department and two new types of specific administration courts, a Chamber of first instance and a Chamber of appeal, chaired by a magistrate.
In addition, the system focused on prevention, deterrence and detection. For example the MEID publishes an infobox to inform healthcare providers about the rules of the healthcare benefit insurance and explaining the types of grievances and sanctions. A system called “Unique Bar Code” (UCB) was set up to facilitate fraud detection in drug prescriptions.
Dr Bernard Hepp said:
“Healthcare is too important for all European citizens. Every effort has to be made to protect healthcare systems from fraud and ensure that healthcare resources are used in an optimal way and for their intended purpose, i.e. patient care.”
“As an EHFCN member I hope both EHFCN awards will entice other organisations to join forces to fight fraud and corruption throughout Europe for the ultimate well-being of every patient.”