- The Washington Times - Wednesday, June 25, 2014

The Obama administration said Wednesday its “state-of-the-art” anti-fraud systems prevented more than $210 million in improper Medicare payments in fiscal 2013, its second year in use and twice the amount it saved in the inaugural year.

Using technology to analyze billing patterns, the Centers for Medicare and Medicaid Services (CMS) boasted in a report to Congress that it took action against 938 health providers and suppliers.

CMS is using the best of private sector technology to move beyond the ‘pay-and-chase’ approach to protect the Medicare Trust Funds,” CMS Administrator Marilyn Tavenner said. “While CMS is continuing to enhance the Fraud Prevention System we have demonstrated that investing in cutting-edge technology pays off for taxpayers and Medicare beneficiaries.”

The system is part of a broader anti-fraud strategy that has led to $19.2 billion in fraud recoveries over the last five years, according to CMS.


Fighting Medicare fraud is a high priority for Congress, as an aging baby-boomer population threatens the program’s solvency.

Prosecutors and government auditors have pointed to home health services as a key source of fraud. Providers frequently fail to conduct face-to-face checkups on beneficiaries, according to government reports, and some scammers coach patients to exaggerate their symptoms so they can inflate billing.