Kuyambira koyambirira kwa 2020, matenda a coronavirus 2019 (COVID-19), omwe amayamba chifukwa cha matenda oopsa kwambiri a kupuma kwapamtima coronavirus 2 (SARS-CoV-2), asintha kwambiri moyo wa anthu komanso chisamaliro chaumoyo m'dziko lonselo. Kukhudzidwa kwa kachiromboka kudapangitsa kuti pakhale kusintha kofunikira pazaumoyo mdziko muno. Chifukwa cha zosinthazi, ziwopsezo zomwe zingachitike zadziwika zomwe zidapangitsa kuti ochita zoyipa azitha kusintha njira zachinyengo zomwe zidalipo kale, zinyalala, ndi nkhanza. Poyankha, Healthcare Fraud Prevention Partnership (HFPP), mwatsatanetsatane pansipa, yatulutsa pepala lake loyera laposachedwa lotchedwa, "Chinyengo, Zinyalala, ndi Abuse mu Context of COVID-19".

HFPP ndi mgwirizano wodzifunira womwe mamembala ake amagwira ntchito kuti azindikire ndikuletsa chinyengo, kuwononga, ndi kuzunza m'magulu onse azachipatala. Othandizira a HFPP akuphatikiza boma la feduro, mabungwe aboma, okhazikitsa malamulo, mapulani a inshuwaransi yazaumoyo, ndi mabungwe odana ndi chinyengo. Othandizira a HFPP awa akuyimira pafupifupi 75% ya moyo wophimbidwa ku United States. Cholinga chachikulu cha HFPP ndikuletsa zinyalala, chinyengo, ndi nkhanza zisanayambike - komanso ndalama zachipatala zisanatayike kapena kubedwa.

Cholinga cha pepala loyerali, lopangidwa ndi malingaliro achindunji kuchokera kwa HFPP Partners komanso mogwirizana ndi ofufuza ochokera ku Stanford University's School of Medicine, ndikuti apereke maziko oyambira pa COVID-19, kuyesetsa kuyesa ndikuchiza kachilomboka, ndi zosintha. ku machitidwe ndi ndondomeko zomwe zakhazikitsidwa kuti zipititse patsogolo chithandizo chamankhwala panthawi ya Public Health Emergency (PHE). Pepalali likuwonetsa njira zachinyengo zomwe zikuchitika kuphatikiza kubweza kwa ntchito zomwe zingakhale zosafunikira, kulemba ma code ndi kulipira molakwika, kupempha mwachindunji ndikuzindikira kuba. Pomaliza, pepala loyera limapereka njira ndi zochita kuti omwe amapereka chithandizo chamankhwala aziganizira ndikuzigwiritsa ntchito. Njira zofotokozedwa ndi izi:

• Kuchulukitsa mgwirizano ndi omwe akukhudzidwa ndikugwiritsa ntchito kusanthula kwatsatanetsatane kuti mufulumizitse ndi kulimbikitsa zowunikira

• Kuchita ndi kuthandizira kutsata malamulo poonjezera kulankhulana ndi akuluakulu azamalamulo pazovuta zomwe zadziwika.

• Kuphunzitsa opereka chithandizo za kusintha kwa ndondomeko ndi mamembala, opindula, ndi odwala njira zabwino zopewera chinyengo, kuwononga, ndi nkhanza

Mwambiri, pepala loyera ili likufotokoza njira zofunika zomwe mabungwe aboma ndi aboma, omwe amalipira zinsinsi, ndi oyang'anira malamulo atenga pozindikira ndikuyankha zachinyengo, zinyalala, ndi nkhanza zokhudzana ndi kupereka chisamaliro ku COVID-19. Zochita izi ndi maphunziro omwe aphunziridwa zitha kulola maphwandowa kuyembekezera zofooka zomwe zikupita patsogolo, ndikupereka maziko oyendera malo osinthika azachipatala ndi zovuta zamtsogolo.

ZOMWE MUNGACHITE PA NKHANIYI:

The goal for this white paper, developed with direct input from HFPP Partners and in collaboration with researchers from Stanford University’s School of Medicine, is to first provide a foundational background on COVID-19, efforts to test for and treat the virus, and the changes to practices and policies implemented to improve the delivery of healthcare during the Public Health Emergency (PHE).
Broadly, this white paper outlines important steps that federal and state agencies, private payers, and law enforcement have taken in identifying and responding to fraud, waste, and abuse related to the delivery of care for COVID-19.
The HFPP is a voluntary public-private partnership whose members work to identify and prevent fraud, waste, and abuse across the healthcare sector.