The FBI will present an overview of the United States healthcare system, the main healthcare fraud schemes against public and private healthcare programs, and FBI initiatives to detect and mitigate healthcare fraud.

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Presentation of a detected fraud case of a Pharmacist claiming for dispensing drugs and consumables to beneficiaries of General Healthcare System.

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Digitisation in healthcare requires digitisation in data. Data are required as a material for the development and use of AI-driven healthcare solutions. However, as a material, how different is it from other types of materials? Can it be raw, or should it be processed? Can data be considered a commodity and what are the rules for delving?

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Providing healthcare services in Estonia means you must be as transparent as possible. In Estonian Health Insurance Fund, they have built a system for healthcare providers where they can see all the services for example an hospital has provided and what was the cost of it. The system has a catch – everybody can see this data. This has made the system transparent and reduced the likelihood of fraud as we have two layers of protection – we are watching and your neighbour as well.

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In 2023, the cybersecurity landscape witnessed a significant increase in both the variety and quantity of cyberattacks and their consequences. Maria Papaphilippou, Cybersecurity Officer at the European Union Agency for Cybersecurity (ENISA), will comment for us the ENISA Threat Landscape report: she will explain us the current state of cybersecurity mainly within the European Union (EU). She will provide insights into emerging trends in terms of cybersecurity threats, threat actors’ activities as well as vulnerabilities and cybersecurity incidents.

 

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The European Union budget finances a wide range of programmes and projects which improve the lives of citizens across the EU.The European Anti-Fraud Office, OLAF, investigates fraud against the EU budget, corruption and serious misconduct within the European institutions, and develops anti-fraud policy for the European Commission. Our speaker will explain us the missions and the activities of OLAF and will detail investigation matters.

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The Polish health sector has become a huge source of data in recent years, much of which is available in real time. That opens new possibilities in a field of fraud detection and prevention. Polish public health institutions have successfully employed various techniques to that data making fraud detection much more effective. However, ability to easily spot fishy activity creates problems of its own.

 

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The European Union is proposing the first-ever legal framework on Artificial Intelligence (AI), which addresses the risks of AI and positions Europe to play a leading role in the world. This Webinar will provide a general overview of AI in Europe, its challenges and its fears.

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Based on a report from CHR. MICHELSEN INSTITUTE (independent development research institute in Norway), her author, Daniela Cepeda Cuadrado, will recount how corruption materialised during Covid-19, what drove it and how it impacted people.

 

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This Webinar will present you 2 concrete current European fraud case examples. They are relevant to state and private medical cost coverage. These current fraud cases will certainly shed light on the new fraud methods used by fraudsters. We will also help you to better understand how to discover, analyze and solve these fraud cases.

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Each country has a rather broad interpretation of the European privacy legislation. For example, some practices are prohibited in one country, while in another they are permitted.

In the Netherlands, as soon as a case of fraud by a service provider is proven, the public is entitled to be informed. This is not the case in Belgium. Why is that?

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The aim of the Falsified Medicines European Directive regulation is to do everything possible to establish a system of unique identification, on the basis of which each medicine can be traced from production to the patient. This unique identification calls 2D Matrix. You will discover a pharmacy fraud case targeting 2D Matrix.

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This Webinar will present a 2022 show-case, revealing opportunities of prediction, prevention and benefits of fraud alerts. You will find out how fraud alerts can help predict and prevent fraud with a concrete fraud case example.

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What is a conflict of interest (COI)? Funding of medical research in Germany, role of pharmaceutical companies,
political influence, laws, publications, peer-review, guidelines, international comparisons.

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The goal of this webinar is to explain the new anti-corruption mechanisms enforced by the Portuguese government, in particular the whistleblowing channel, the whistleblower protection and the risk management, corruption and related offenses prevention plan. 

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A business case of how we implemented Artificial Intelligence to enhance the treatment of paper billing.
Description of the project.

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The Corruption Perceptions Index (CPI) from Transparency International ranks 180 countries and territories around the world by their perceived levels of public sector corruption. The results are given on a scale of 0 (highly corrupt) to 100 (very clean).
Check out the latest corruption wins, scandals and predictions for each region of the world. 

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The Anti-counterfeiting Technology Guide was made by the Observatory of the European Union Intellectual Property Office (EUIPO) to explain to all types of stakeholders, in a clear and simple language, which technologies exist to protect goods against counterfeiting.

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The National Health Organization of Greece for health care provisions (EOPYY) and the National Health Fund (CNS ‘d’Gesondheetskeess’), 2 EHFCN-Members, show the effectiveness of Artificial Intelligence in the fight against fraud in the healthcare sector, with very concrete applications and tools.

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Muel will present different approaches of defining, understanding and managing integrity at work and finish with some takeaways.

He will focus on how (people in) organizations can understand/manage the integrity of their organizations/work (so he will not focus on fraud and corruption of consumers).

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Fraud and corruption risk analysts, in the field of health services, often work in de-contextualized scenarios, where relationship between doctors and patients lies in the background of organizational vulnerabilities and lack of rules. The webinar will offer insights and concrete suggestions on how to strengthen role perception on both sides and build ecological relationships.

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Introduction of of the Informatie Knooppunt Zorgfraude (IKZ), an organisation that helps nine organisations in the Netherlands to combat healthcare fraud.
The IKZ has two goals: enrich signals of healthcare fraud and report trends and phenomena.

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Since its inception in 1995, the Corruption Perceptions Index from Transparency International has become the leading global indicator of public sector corruption. Their report reveals that persistent corruption is undermining health care systems and contributing to democratic backsliding amid the COVID-19 pandemic. Explanations & recommendations.

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The first part of the Webinar will introduce ENISA, the EU agency for Cybersecurity, and will present a situational analysis of cybersecurity in healthcare, and will give an overview of the EU policy and regulatory framework. The second part of the Webinar will focus on GDPR and its impacts on health rights.

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This Webinar will present a number of challenges associated with the sharing of data, including obstacles to
releasing data, privacy and confidentiality problems, and informed-consent issues. 

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Artificial intelligence (AI) has the potential to transform how healthcare is delivered. The benefits of AI are many. But questions have been raised about its potential impact on the health care sector due to the use of personal data, issues around ethics and data integrity concerns. What is true and what is false? We will discuss the current and future applications of AI in healthcare.

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Studies on waste in health care have shown that the largest share lies in the inappropriate use of health services. Our inspection services invest a lot in checking the reality and conformity of healthcare services, on the basis of well-established regulations. Tackling ‘inappropriate care’ however requires a different frame of reference, scientific evidence or indicators of good practice to carry out actions aimed at stimulating proper use of health services.

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We attend all participants to be aware for the importance to have and develop integrity programmes on their organizations, and will explain how they can do it, particularly with reference to public procurement and its linked data treatment and processing, according to OECD recommendation (OECD 2020). We will demonstrate how we audit the integrity framework of the healthcare providers.

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The detection and prevention of healthcare fraud crucially depends on the availability of the necessary data. Delays and constraints inherent in long-standing and only partially digitalized health insurance systems can pose significant challenges to the fight against fraud, whereas more modern systems or digital transformation provide opportunities to increase the efficiency of our inspection efforts.

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The identified amounts of healthcare fraud increase each year. Fraud is by nature hidden and therefore difficult to assess. However, social protection organizations have to engage in a better estimate of their risk of fraud.

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This webinar gives an insight in the (ab)use of opioids in Belgium and France highlighting the specific case of Tramadol. Different fraud and abuse schemes will be disclosed with an assessment of available actions to tackle this issue.

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Inspection services tackling errors, abuse and fraud in healthcare use a wide range of possible actions. Some as group communication or structural control measures are mainly implemented to prevent infringements. A question is raised on how to estimate the impact of these actions for the future. The gathered experience suggests that these deferred effects are still marginalized by third parties and underreported.

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