The federal government's systems to analyze Medicare and Medicaid data to identify fraud are inadequate and underused, according to a report released by the U.S. Governmnent Accountability Office yesterday.
The report examines the efficiency of two initiatives that were launched by CMS in 2006 — the Integrated Data Repository and the One Program Integrity System.
The report found that IDR does not yet include Medicaid data critical to detecting fraud and abuse in the program. It also says CMS had planned to train 639 analysts in One PI, but by the end of Oct. 2010, only 42 of those intended users had been trained and only 41 were actively using the tools.
The report says the agency's current implementation of IDR and One PI does not strongly position CMS to identify, measure and track fraud and abuse.
Read the GAO report on CMS and its Medicare and Medicaid fraud initiatives (pdf).
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The report examines the efficiency of two initiatives that were launched by CMS in 2006 — the Integrated Data Repository and the One Program Integrity System.
The report found that IDR does not yet include Medicaid data critical to detecting fraud and abuse in the program. It also says CMS had planned to train 639 analysts in One PI, but by the end of Oct. 2010, only 42 of those intended users had been trained and only 41 were actively using the tools.
The report says the agency's current implementation of IDR and One PI does not strongly position CMS to identify, measure and track fraud and abuse.
Read the GAO report on CMS and its Medicare and Medicaid fraud initiatives (pdf).
Related Articles on CMS and Fraud:
CMS to Adopt Predictive Fraud-Fighting Technology July 1
HHS Inspector General Recommends CMS Respond to Fraud Hotline Complaints More Promptly
GAO Study Outlines Key Strategies to Reduce Fraud in Medicare, Medicaid