PQA Managing Partner Ken Pringle spoke on October 5, 2011 at a New Jersey Health Care Quality Institute forum held on health care fraud in New Jersey at the Trenton Country Club. Pringle outlined the “PIP Convey Belt,” and described a variety of patient solicitation and kickback schemes used by lawyers and healthcare providers to solicit recent accident victims to begin undergoing treatments and to induce them to pursue further testing and treatment, including invasive procedures and surgeries.
The other speakers at the event were Supervisory Special Agent Sean Keyes of the NK Squad C-12 (Health Care and Mortgage Fraud Squads) of the FBI’s Newark Field Office; Ron Chillemi, the Acting Insurance Fraud Prosecutor; and Assistant Attorney General John Kennedy.
Founded in 1997 and partially funded by a grant from the Robert Wood Johnson Foundation, the NJHCQI brings together all key stakeholders to make real and measureable improvements to our state’s health care system. Its purpose is to “undertake projects that will ensure that quality, accountability and cost containment are closely linked to the delivery of health care services in New Jersey.” These links are made by publishing the results of objective research, comparative data on providers and other pertinent educational information. This allows purchasers and consumers to adopt value-based purchasing practices and make highly informed decisions, based on the merits of the various health care programs, treatments and services.