Senators Call for Better Metrics to Assess CMS' Predictive Modeling Program for Fraudulent Claims

Senate Federal Financial Management Subcommittee Chairman Tom Carper (D-Del.), Ranking Member Scott Brown (R-Mass.), and Sen. Tom Coburn (R-Okla.) yesterday sent a letter to Peter Budetti, director of CMS' Center for Program Integrity calling for better metrics to assess the agency's implementation of the predictive analytics program designed to prevent waste, fraud and abuse in Medicare, according to a news release.

In the letter, the Senators express concerns that CMS may not have sufficient metrics and processes in place as to ensure the success of the program and state the success or failure of the program will be difficult to measure unless metrics are put in place. "In the absence of established and consistent measures designed to track the operation of predictive analytics, we are highly concerned that the Centers for Medicare and Medicaid Services and Congress will be unable to properly oversee this important program," wrote the Senators.

CMS has since responded that it is measuring the results of the program, which launched in July, and plans to report the results to Congress in the near future, according to a Nextgov report.

Related Articles on Medicare Fraud Prevention:

What Does CMS' Predictive Modeling System Entail?
CMS to Adopt Predictive Fraud-Fighting Technology July 1

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