National Fraud Initiative

The Public Health Agency is required by law to protect the public funds it administers. This A4 sheet provides information on the National Fraud Initiative.

National Fraud Initiative

The Public Health Agency (PHA) is required by law to protect the public funds it administers. This A4 sheet provides information on the National Fraud Initiative.

HSS(F) 39-2008 DHSSPS Sanctions and Redress Policy (PDF 95KB)

The Department’s Sanctions and Redress Policy sets out an approach to be applied throughout the Department, HSC and associated bodies in respect of disciplinary, civil and criminal proceedings and financial recovery against those persons/organisations who have committed fraud.

Review of Measures to Reduce Costs in the Private Health Insurance Market 2013

This report was prepared independently by Mr McLoughlin with the insurers support, for consideration by the Minister for Health and the insurers.  All parties were very conscious of the importance of respecting competition law when dealing with issues such as prices and costs. The Phase 1 report contains 32 recommendations under 9 headings as follows: Most of the recommendations in the Phase 1 report could be implemented on an administrative basis, while a small number, if adopted, would require legislation. Some of the key recommendations to drive down costs are can be summarised as follows: Controlling costs in private health insurance Care settings and use of resources Age structure of the market Clinical audit and utilisation management Industry approach to private psychiatry Fraud, waste and abuse Chronic disease management Claims processing Admission and discharge procedures and processes. Most of the recommendations in the Phase 1 report could be implemented on an administrative basis, while a small number, if adopted, would require legislation.