The Department of Health and Human Services on March 17 will publish a proposed rule enabling federal funds to be used for state Medicaid fraud control units to conduct mining of their states' Medicaid claims data.

The rule, from the HHS Office of Inspector General, amends current regulations that prohibit use of federal matching funds for data mining. Fraud units currently rely on referrals from state agencies, providers and private citizens to identify possible cases of fraud.

Permitting federal funding in data mining activities will be an efficient use of available resources, the Office of Inspector General declares in the proposed rule. "At the federal level, analysis of claims data has increased OIG's effectiveness in deploying law enforcement resources and proactively identifying suspected fraud."

The proposed rule, with a 60-day comment period, is available here and available in the Federal Register on March 17.

--Joseph Goedert

 

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