Home Health & Hospice Week
Fraud Data Crunching Leads To 10-To-1 ROI
CMS is tooting its own horn when it comes to its fraud-fighting data crunching. “The agency’s advanced analytics system, called the Fraud Prevention System, identified or prevented $820 million in inappropriate payments in the program’s first three years,” CMS crows in a release. The system “identified or prevented $454 million in Calendar Year 2014 alone, a 10 to 1 return on investment,” the agency points out.
What it does: The system helps to identify questionable billing patterns in real time and can review past patterns that may indicate fraud, CMS explains in the release.
The system’s most recent results “demonstrate our commitment to high-yield prevention activities, and our progress in moving beyond the ‘pay and chase’ model,” CMS deputy administrator Shantanu Agrawal says.
Ahead: CMS plans to expand the system and its algorithms “to identify lower levels of non-compliant health care providers who would be better served by education or data transparency interventions,” the agency says in the release.
Home Health & Hospice Week
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Fraud Data Crunching Leads To 10-To-1 ROI
CMS is tooting its own horn when it comes to its fraud-fighting data crunching. “The [...]
