Fraud prevention efforts save $42B for Medicare, Medicaid over 2 years

The government saved $12.40 for every one dollar invested in Medicare fraud prevention efforts from Oct. 2012 to Sept. 2014, according to CMS.

Prevention efforts included proper screenings for healthcare providers enrolled in CMS programs, use of predictive analytics to prevent fraud, waste and abuse and coordination of the agency's anti-fraud efforts with external partners.

This is a move away from the government's pay-and-chase recovery method, which retrieves payments after they are already made. CMS said year over year, it is saving more Medicare dollars through prevention efforts versus retroactive recovery. In fiscal year 2013, savings from prevention activities totaled about 68 percent. In 2014, the amount rose to 74 percent.

The preventive measures saved the agency nearly $42 billion during the two year period.

Preliminary information for the 2015 fiscal year indicates a similar magnitude of savings. CMS officials said the agency will release 2015 data later this year.

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