CMS to test federal fraud mapping tool

CMS to test federal fraud mapping tool

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US: The Centers for Medicare and Medicaid Services (CMS) will be the first federal programme agency to test a mapping and data analysis tool developed by a White House oversight board to spot irregularities in the flow of economic stimulus funds.

The software tool was developed by the Recovery Accountability and Transparency Board (RATB). The Board uses maps, tools and templates developed by GIS vendor ESRI to roll up data from the 50 states to show where and to whom the federal funds have gone. Users can drill down for more information about local spending.

CMS will use the software tool to identify potential fraud and abuse as well as inaccurate payments to Medicare and Medicaid providers, which together accounted for USD 65 billion in improper payments last year, according to Peter Orzsag, Director, Office of Management and Budget.

The tool will then become available to all federal agencies to use. In a June 18 blog post announcing the CMS project, Orzsag said, “The tool gathers enormous quantities of information in real time and then analyses the data and helps connect the dots to identify indicators of possible fraud or error.”

The tool will help CMS sort through the thousands of tips it receives about fraud and abuse. The agency will test the tool to identify suspicious providers among a list of providers in geographic regions where the agency has indications of fraud.

The results will help to validate providers already identified as high risk and to spot additional high-risk providers whom the agency previously considered legitimate under the current process, Orszag said.

Source: Government Health IT