Better Analytics Help CMS Catch More Fraud

Medicare’s Fraud Prevention System that uses predictive algorithms to analyze provider billing patterns caught nearly $211 million in improper Medicare payments during the past year.

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Comments (3)
Using data analytics to drive evidence-base solutions is leading the way with reducing health care cost and better quality care. Better Analytics will help CMS provide the best services at better cost in the future.
Posted by George D | Thursday, July 03 2014 at 9:22AM ET
I suppose any recovery is better than none but I don't think this is anything CMS or anyone else should be celebrating because it's an tiny, tiny percentage of overall fraud.

http://www.medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=6a130489-e387-476d-a358-c77cfba68367

And if the ROI is so great, why isn't more money poured over this matter? Who's driving the bus at CMS?
Posted by Steven S | Thursday, July 03 2014 at 11:09AM ET
"Better than none but", Rome wasn't built in a day. As you may know developing predictive algorithms in healthcare is tough at best and as soon as effective one is developed someone develops counter measures. Time and resources will increase recovery rates.
Posted by Michael E | Saturday, July 05 2014 at 5:00PM ET
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