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CMS Describes Predictive Modeling Program to Detect Medicare Fraud

By Debra A. McCurdy on October 28, 2011

CMS has released an educational article for providers and suppliers regarding a predictive analytics system CMS is using as of June 30, 2011 to analyze all Medicare fee-for-service claims to detect potentially fraudulent activity. The predictive analytics system uses algorithms and models to examine Medicare claims in real time to flag suspicious billing. The article briefly explains the new system, its purpose, and how CMS is incorporating predictive modeling into its claims payment process.

  • Posted in:
    Health Care
  • Blog:
    Health Industry Washington Watch
  • Organization:
    Reed Smith LLP
  • Article: View Original Source

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