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Medicare: Predictive analytics working to fight fraud

The Hill, June 26, 2014
The Obama administration announced Wednesday that a new anti-fraud program in Medicare doubled the improper payments it identified or prevented this year. The Fraud Prevention System at the Centers for Medicare and Medicaid Services (CMS) recovered or prevented more than $210 million of improper payments in its second year, the agency told Congress in a report. The program, which uses predictive analytics to analyze billing patterns, also prompted CMS to take action against 938 providers and Medicare suppliers. "CMS is using the best of private sector technology to move beyond the 'pay-and-chase' approach to protect the Medicare Trust Funds," said agency Administrator Marilyn Tavenner in a statement.