In an effort to detect potential fraud and waste in the Medicaid program, the Centers for Medicare and Medicaid Services will use data analysis services provided by Thomson Reuters.
Thomson Reuters was awarded the task order following a competitive procurement process that began in February to identify inappropriate and unnecessary Medicaid payments as part of the federal Medicaid Integrity Program.
Thomson Reuters will analyze Medicaid claims data from the Atlanta Region, which includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee. These eight states have approximately 9 million Medicaid recipients.
After analysis, CMS Medicaid Integrity Group will have audit contractors conduct post-payment provider audits and, where appropriate, identify Medicaid overpayments.
"We are excited about providing our best-in-class data analysis capabilities to assist CMS with their program integrity activities," said Jon Newpol, Thomson Reuters executive vice president. "We are confident our abilities will help CMS meet their program objectives."
Thomson Healthcare currently supports 17 state Medicaid agencies, CMS One Program Integrity, CMS Program Safeguard Contractor, CMS Medicare Drug Integrity Contractor, and CMS Part A and Part B Medicare Administrative Contractor programs. Thomson provides decision support solutions including business intelligence applications, analytic and reporting capabilities, fraud and abuse detection and investigation, analytic database development, data warehousing, data mining, data matching and analysis, financial analysis, quality measurement, provider profiling, patient health records, patient information and activation tools, consulting, and custom research.
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E-mail Associate Editor Molly Merrill at molly.merrill@medtechpublishing.com