Medicare to Check Claims for Fraud Before Paying

Medicare starting July 1 will use predictive modeling technology to identify potentially fraudulent fee-for-service claims before paying them.


Medicare starting July 1 will use predictive modeling technology to identify potentially fraudulent fee-for-service claims before paying them.

The initiative is funded under a provision tucked in the Small Business Jobs Act of 2010. Under the law, the program was to start this year with 10 states and roll out nationwide over three years. Medicare, however, is implementing it nationally ahead of schedule.

Technology vendors for the initiative are Northrop Grumman, National Government Services and the Federal Network Systems unit of Verizon.

 

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