As a self-funded employer, you play a vital role in protecting the integrity of your health care program. In this document you will learn about:
- The problem of FWA facing employers.
- Differentiating between fraud, waste, and abuse.
- Federal laws governing health care regulations.
- What FWA costs your health plan.
- How to protect your dollars.
Examining exactly where health care dollars are spent is not just a budget management or cost-saving practice for business, as plan sponsors are reminded often, it is also a fiduciary responsibility under the Employee Retirement Income Security Act (ERISA).
The City of Fort Worth, Texas — the 12th largest city in the U.S. and the 5th largest in the state — presents a textbook case study for the pervasiveness of pharmacy fraud hidden in health care claims and the action required to combat the ever-evolving abuse.
