The Centers for Medicare and Medicaid Services’ advanced analytics system has identified or prevented $820 million in inappropriate Medicare payments during the first three years of its operation, according to CMS. Yet, questions remain about the overall impact of the system on combating fraud.

The CMS Fraud Prevention System (FPS) uses predictive analytics to help identify suspicious billing patterns in real time and to review past patterns that may indicate fraudulent activity. Directed by the 2010 Small Business Jobs Act, the system was implemented in July 2011 to more proactively prevent fraud in the Medicare program—as opposed to taking a reactive “pay and chase” approach.

Register or login for access to this item and much more

All Health Data Management content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access