CMS is first to try federal fraud detection software

Attention anyone who wants to cheat the system out of "meaningful use" dollars and other stimulus funding: CMS is becoming the first federal agency to try out a government-developed analytics program intended to weed out fraud in the disbursement of American Recovery and Reinvestment Act money. The agency also will use the software to help reduce fraud and abuse--responsible for $65 billion in wasted spending in 2009 alone--in other Medicare and Medicaid activities.

The Recovery Accountability and Transparency Board, set up to track the distribution of funds under the 2009 stimulus bill passed in February 2009, created the software to find irregularities in spending of the $787 billion authorized by the Recovery Act. The program, built by geographic information systems contractor ESRI, can pinpoint the location of funding recipients and generate reports on local spending.

The software "gathers enormous quantities of information--in real time--and then analyzes the data and helps connect the dots to identify indicators of possible fraud or error," Peter Orszag, director of the White House's Office of Management and Budget, writes in in a blog post. CMS says it will use the program to help make sense of the thousands of tips it receives about potential fraud and abuse each year and identify "suspicious" Medicare and Medicaid providers, according to Government Health IT.

Eventually, all federal agencies will have access to the software, which helps support President Obama's "Do Not Pay" list, established to prevent fraudsters from receiving federal money. "The technology for this fraud mapping tool and a Do Not Pay List database exist, yet the government was not using it," Orzsag writes. "We pay a price in allowing the IT gap between the public and private sectors to persist."

For further details:
- read this Government Health IT article
- see Orszag's post on the OMB blog

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