There are a few people in this country concerned about misuse of healthcare funds even though our governments apparently aren’t.
One such individual is a former RCMP officer by the name of John Robert Lyons. Per his profile on LinkedIn, he was a peace officer with the RCMP for 27 years and prior to his retirement from public service was a fraud risk consultant with the Ontario Ministry of Health and Long-Term Care.
He, with a partner from the United States, now operates The ATRiM Group LLC, a company which provides “services assisting the health care sector deliver counter-fraud training and strategies based in crime prevention science.”
Lyons provided the Monitor Telegram with a copy of a paper he has published on healthcare fraud in Canada. So we are providing it here for our readers.
[pdf-embedder url=”https://https://monitortelegram.com/wp-content/uploads/2017/08/HCSWhilePaper28final29.pdf” title=”_HCS+While+Paper+final”]
John Lyons says
Since drafting this White Paper, an associate, Joel Alleyne, and I make a clear distinction between waste/misuse/abuse and predatory fraud. We think protecting people from cheating when tempted to do bad things is a different business than reducing the predatory fraud threats posed by people without moral conscience (i.e. organized crime groups).
Joel is the former director of the now defunct Canadian Healthcare Anti-fraud Association (CHCAA).
For reasons unknown to me, the insurance industry withdrew its financial support for the CHCAA, to align with Canadian Life and Health Insurance Association (CLHIA). At least publicly, it appears to be a myopic to a more near sighted strategy. There has been a decline in education and experiential learning – the sharing of insights from being in action to counter fraud:
https://www.clhia.ca/domino/html/clhia/CLHIA_LP4W_LND_Webstation.nsf/0/10D0B370160E723B85257F03005BD980?OpenDocument
For more information my contact email is jlyons.atrim@gmail.com