The mission of the Global Health Care Anti-Fraud Network (GHCAN) is to promote partnerships and communications between international organizations in order to reduce and eliminate health care fraud around the world. GHCAN aims to further this mission by:
- Raising awareness internationally about the issue of health care fraud.
- Gathering and sharing information on the trends, issues, facts and figures relating to the problem.
- Working cooperatively to improve international standards of practice around fraud prevention, detection, investigation and prosecution.
- Developing joint educational training programs in order to bolster and prepare the world’s health care anti-fraud professionals.
GHCAN was jointly founded by the Canadian Health Care Anti-Fraud Association, the European Healthcare Fraud & Corruption Network, the Health Insurance Counter Fraud Group (based in the United Kingdom), the Healthcare Forensics Management Unit (based in South Africa), and the National Health Care Anti-Fraud Association (based in the United States).
About the Founders
||The Canadian Health Care Anti-fraud Association (CHCAA)
Founded in 2000 to give a voice to the public and private sector health care organizations interested in preventing fraud in the Canadian health care environment. The CHCAA’s Vision is to improve the Canadian Health Care environment by eliminating health care fraud and its Mission is to combat health care fraud and assist in restoring the integrity of the Canadian health care system. One of the key objectives of the CHCAA is to build public, private, national and international partnerships with insurance carriers, service providers, law enforcement, health regulatory bodies, consumer groups and provider associations to protect the Canadian health care system from fraud.
||Canadian Life and Health Insurance Association (CLHIA)
Established in 1894, CLHIA is a voluntary non-profit association with member companies accounting for 99 percent of Canada’s life and health insurance business. The mission of the CLHIA is to serve its members in areas of common interest, need or concern. In carrying out this mission, the Association shall ensure that the views and interests of its diverse membership and of the public are equitably addressed.
The European Healthcare Fraud & Corruption Network (EHFCN)
Established in 2005, EHFCN is the only European organization dedicated to combating healthcare fraud and corruption across Europe. The network represents 25 member associations in 15 countries, which provide healthcare services to millions of people in Europe. EHFCN’s primary objective is to reduce fraud and corruption in healthcare: reducing losses will help bring back money to healthcare services for the benefit of every patient. EHFCN provides information, tools, training and assistance in fighting fraud and corruption as well as a platform for its members to exchange information and ideas. EHFCN is a not-for-profit organization based in Brussels and financed through subscription fees.
||The Healthcare Forensic Management Unit
The Healthcare Forensic Management Unit (HFMU) is an information and resource sharing group which enjoys the participation of the majority of medical schemes, administrators, management and administration entities and some insurers. The core focus of this unit is to facilitate a unified approach with regards to fraud in the medical schemes environment. This is achieved by sharing information regarding fraud, over billing and over servicing in order to minimise fraud across the industry and to protect medical schemes from healthcare providers and medical scheme members who shift their wrongdoings from one medical scheme to another once “caught out”. The HFMU is coordinated and administrated under the auspices of The Board of Healthcare Funders of Southern Africa and is unique in that it is the only initiative of its kind within the healthcare industry.
||The Health Insurance Counter Fraud Group UK (HICFG)
HICFG is an industry initiative to prevent and detect fraud within health care and the health insurance industry within the United Kingdom. The HICFG membership consists of health insurance companies and is supported by the Association of British Insurers and participated by non-member attendees in the City of London Police and NHS Counter Fraud. The HICFG is dedicated to a professional, intelligence-based approach to minimizing fraud within private medical insurance and to advancing professional skills of industry-based counter fraud professionals. HICFG is also committed to raising the public profile of health care and health insurance fraud in the UK.
||The National Health Care Anti-Fraud Association (NHCAA)
Established in 1985 by several private health insurers and federal and state government officials, NHCAA is the only national U.S. organization devoted exclusively to combating health care fraud. NHCAA’s mission is to protect and serve the public interest by raising awareness and improving the detection, investigation, prosecution and prevention of health care fraud. Since its founding, NHCAA has remained a private-public partnership with its members comprising the nation’s most prominent private health insurers as well as those Federal, state and local government law enforcement and regulatory agencies having jurisdiction over health care fraud