Medicare Fraud is Ripe for a Tech Solution, But It's Complicated
Adrian Gropper, MD is PPR's chief technology officer. He has a deep understanding of NSTIC's concept of the identity ecosystem. We spoke last week and I noted the irony that NSTIC faces challenges receiving further funding to solve the identity problem the right way, while at the same time H.R. 3024 proposes allocating $29 million for the Medicare Smart Card pilot.
Maybe these two government initiatives should get together and share expertise and funds, I suggested to Gropper.
"That's a very nice idea," Gropper told me.
Now before you write me, yes there are many other ways to fight Medicare fraud with technology other than figuring out the identity and smart card problems. Algorithms are already at work, and getting smarter, at detecting patterns of abuse. The Medicare regulations themselves probably still contain an encyclopedia's worth of loopholes that permit waste and fraud, loopholes that should be closed.
But in an age when libraries do a better job of protecting our privacy than healthcare does, and when the average wallet has an impressive array of security-powered smart cards, surely Medicare, and the rest of the healthcare system, can be doing better than it is.
Scott Mace is senior technology editor at HealthLeaders Media.
- CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services
- FDA hopes hospitals will switch to newly regulated pharmacies
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- States Rejecting Medicaid Expansion Forgo Billions in Federal Funds
- Why You Should Involve Patients in Nursing Handoffs
- Not-for-Profit Hospitals Find Opportunity Amid Uncertainty
- The Most Polarizing Topics in Healthcare IT
- Substance Abuse Resurfaces Among Anesthesiologists in Training
- Safety Net Executives Renew Call to Preserve DSH Payments
- The 5 Biggest Healthcare Finance Trouble Spots