Former CMS administrator says fraud detection is better, but gaps remain

The transition from a reactive approach to relying on claims data to better predict and prevent fraudulent payments has led to significant progress in fighting Medicare and Medicaid fraud, former Centers for Medicare & Medicaid Services (CMS) Administrator Don Berwick told the Journal for the American Medical Association (JAMA).Berwick (pictured right), who served as the CMS Administrator from July 2010 to December 2011, says the agency began the shift toward predictive analytics under his leadership. That transition continued even after his tenure, which has led to a greater degree of enforcement actions and criminal prosecution.

Source: Former CMS administrator says fraud detection is better, but gaps remain – FierceHealthPayerAntiFraud

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