AHIMA FOUNDATION NAMES EXECUTIVE COMMITTEE FOR ANTI-FRAUD HEALTH CARE FRAUD PROJECT
Project is Part of Larger Anti-Fraud Study being Conducted by AHIMA under Contract from the National Coordinator’s Office

CHICAGO, June 15—The Foundation of Research and Education (FORE) of the American Health Information Management Association (AHIMA) has appointed a group of industry experts to participate in a cross industry Anti-Fraud Health Care Executive Committee. The committee will identify best practices to enhance the capabilities of a nationwide interoperable health information technology infrastructure to assist in health care fraud prevention, detection and prosecution.

“We have assembled an exceptional panel of leaders whose cross-industry expertise will assure robust recommendations to guide the development of information technology systems able to impede healthcare fraud,” says committee chair Arnold Milstein, MD, MPH, Chief Physician at Mercer Human Resources Consulting and Medical Director of the Pacific Business Group on Health.

The project is part of the larger anti-fraud study being conducted by FORE—under contract to the Office of the National Coordinator for Healthcare Information Technology (ONCHIT)—to look at how automated coding software and a nationwide interoperable health information technology infrastructure can address healthcare fraud issues. The committee members include:

• Arnold Milstein, MD, MPH, Chief Physician at Mercer Human Resources Consulting and Medical Director of the Pacific Business Group on Health, Committee Chair
• A. John Blair, III, MD, CEO, Taconic IPA
• Bob Burleigh, CHBME, President, Brandywine Healthcare Services
• Rebecca S. Busch, RN, MBA, CCM, CBM, CHS-III, CFE, FHFMA, CEO and President, Medical Business Associates, Inc.
• Timothy J. Coleman, J.D. Senior Counsel to Deputy Attorney General, Department of Justice
• Kenneth F. Faustine, Fraud Manager, Cigna
• Donna Hoffmeier, Vice President of Government Affairs, Strategy and Policy, UnitedHealth Group
• Richard Ingraham, Senior National Industry Strategist, SAS US Commercial – Health & Life Sciences
• Stephen L. Jones, DHA, Principal Deputy Assistant Secretary of Defense for Health Affairs, Department of Defense
• Jeff J. Matza, AHFI, CFE, Vice President, Special Investigations, Mutual of Omaha Company
• Patricia E. Monahan, Chief Technology Executive, Blue Cross and Blue Shield Association
• Lewis Morris, JD, Chief Counsel to the Inspector General, Department of Health and Human Services, Office of the Inspector General
• Maureen Mudron, JD, Washington Counsel, American Hospital Association
• Stephen Parente, PhD, MPH, MS, Assistant Professor, Department of Healthcare Management, Carlson School of Management, University of Minnesota
• Alison Rein, MS, Assistant Director of Food and Health Policy, National Consumers League
• Beth Schermer, JD, Partner, Coppersmith Gordon Schermer Owens & Nelson P.L.C.
• Donald W. Simborg, MD, Independent Consultant
• James Speros, MD, Manger, Evaluation and Assessment Service, Office of Compliance and Business Integrity, Veteran’s Health Administration
• Johnathon Topodas, JD, Vice President and Counsel, Federal Government Relations, law & Regulatory Affairs, Aetna Inc.
• Susan Turney, MD, MS, FACP, CMPE, Executive Vice President and CEO, Wisconsin Medical Society
• Jean de Traversay, Director of Healthcare Analytics, Fair Isaac Co.
• Alan Yuspeh, JD, MBA, Senior Vice President of Ethics, Compliance and Corporate Responsibility, Hospital Corporation of America

At their first meeting on May 24 in Washington, DC, the committee was charged with the following tasks:

1. Identifying basic principles applicable to antifraud activity, focusing on the areas of technology infrastructure, management practices and processes, human interaction, (including consumer roles), and the legal and regulatory environment
2. Reviewing and discussing the proposed economic models to value healthcare anti-fraud
3. Drafting the outline for the final committee report and recommendations

The final report is scheduled to be completed in September 2005.

ABOUT AHIMA
AHIMA is the premier association of health information management (HIM) professionals. AHIMA's 53,000 members are dedicated to the effective management of personal health information needed to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the HIM profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning. For information about the Association, go to http://www.ahima.org. FORE provides financial and intellectual resources to sustain and recognize continuous innovation and advances in HIM for the betterment of the profession, healthcare, and the public. For more information about FORE, go to http://www.ahima.org/fore/.

ABOUT ONCHIT
The mission of ONCHIT is to implement the President's vision for widespread adoption of interoperable electronic health records (EHRs) within 10 years. Appointed in May 2004, Dr. David Brailer, M.D., Ph.D., National Coordinator of Health Information Technology, serves as the senior advisor to the Secretary of Health & Human Services and the President of the United States on all health information technology programs and initiatives. Dr. Brailer’s office develops and maintains strategic plans to guide the nationwide implementation of interoperable EHRs in both the public and private healthcare sectors, helps coordinates health information technology programs and initiatives across the federal enterprise, coordinates all outreach activities to the private industry, and serves as the catalyst for healthcare industry change. For more information about ONCHIT, go to http://www.os.dhhs.gov/healthit/.