Monday, August 6, 2012

Medicare Fraud Command Center Seeks to Stop Fraud Before It Gets Expensive

The federal government has launched a new $3.6 million Medicare Command Center that is designed to detect and deter Medicare fraud before it costs the government billions of dollars.  The new command center located outside Baltimore, Maryland, is home to teams of data analysts and the latest computer and communications technologies.

Medicare fraud is estimated to cost more than $60 billion each year.  Law enforcement has traditionally combated fraud through a process of "pay and chase," trying to recoup money after the fraudulent claims have already been paid.  In may cases, this is a losing battle with thieves filing millions of dollars in bogus claims and collecting he money before their fraudulent schemes are even identified.

The new Medicare Command Center will use a combination of 21st century computer analytics and old-fashioned street investigations to identify fraud before it becomes very expensive.  

Staff members at the center are developing computer models to query billing data for suspicious patterns, much as credit card companies use computer tools to detect fraudulent credit card transactions.  The commend center’s staff analyzes data generated by the computer models to identify mistakes or fraud before large payments are made.

Investigators at the center can communicate directly with law enforcement officers on the ground to coordinate investigations.   The coordination is expected to cut the time it takes to investigate suspected fraud schemes from months to days and weeks. 

New York, New York

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