CMS partners to move beyond 'pay and chase' anti-fraud efforts

The Centers for Medicare and Medicaid Services revealed intentions to tap predictive modeling to root out Medicare fraud last month, and now has announced the technology and vendors that will make that happen. Verizon, alongside Northrop Grumman and WellPoint subsidiary National Government Services, has helped develop a technology for the Centers for Medicare & Medicaid Services that improves detection and prevention of fraud and waste. The new platform incorporates predictive modeling technology from Verizon to transform the way Medicare fraud is detected, and officials say it will provide CMS with a scalable and automated solution that scrutinizes incoming Medicare program claims, routing those that may be fraudulent to case managers for investigation.