Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501)

Section 1128C(a)(2) of the Social Security Act (42 U.S.C. 1320a-7c(a)(2)) authorizes the Secretary and the Attorney General to consult with, and arrange for the sharing of data with representatives of health plans to establish a Fraud and Abuse Control Program as specified in Section 1128(C)(a)(1) of the Social Security Act. This is known as the Healthcare Fraud Prevention Partnership (HFPP). It was officially established by a Charter in fall 2012 and signed by HHS Secretary Sibelius and US Attorney General Holder. The HFPP is a joint initiative established by the Department of Health and Human Services and Department of Justice to detect and prevent the prevalence of healthcare fraud through data and information-sharing and applying analytic capabilities by the public and private sectors. The HFPP collaboration provides a unique opportunity to transition from traditional "pay and chase" approaches for fraud detection and recovery towards a data-driven model for identifying and predicting aberrant activity. A central goal of the HFPP is to identify the optimal way to coordinate nationwide sharing of health care claims information, including aggregating claims and payment information from large public healthcare programs and private insurance payers. In addition to sharing data and information, the HFPP is focused on advancing analytics, training, outreach, education to support anti-fraud efforts and achieving its objectives, primarily through goal-oriented, well-designed fraud studies. The HFPP's organizational structure is made up of an Executive Board, the Data Analysis and Review Committee, and the Information Sharing Committee. The HFPP will also include a Trusted Third Party that CMS will engage to provide the technical and operational platform to support the partnerships' data sharing, collaboration and study outreach activities. Enabling data sharing and providing analytical computing capabilities of the TTP is central to the success of the HFPP.

The latest form for Healthcare Fraud Prevention Partnership (HFPP): Data Sharing and Information Exchange (CMS-10501) expires 2021-12-31 and can be found here.