CMS’ Fraud Prevention System identifies $820M in improper Medicare payments

CMS’ advanced analytics system, called the Fraud Prevention System, identified or prevented $820 million in inappropriate payments in the program’s first three years, including $454 million in 2014 alone.

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The system was created in 2010 by the Small Business Jobs Act, and it uses predictive analytics to identify questionable billing patterns.

“We are proving that in a modern healthcare system you can both fight fraud and avoid creating hassles for the vast majority of physicians who simply want to get paid for services rendered,” said CMS Acting Administrator Andy Slavitt in a news release.

CMS said it has plans to expand the Fraud Prevention System and its algorithms to identify lower levels of non-compliant healthcare providers in the future.

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