#program-integrity

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Healthcare
fromFox News
2 weeks ago

Dr Oz alleges widespread fraud in New York's $100B Medicaid program, demands Hochul respond

CMS Administrator Dr. Mehmet Oz is investigating New York's Medicaid program for widespread fraud, citing spending that far exceeds national averages and requesting detailed information within 30 days.
fromwww.mediaite.com
2 months ago

Tim Walz Defends Aggressive' Record Against Fraud Despite Viral Minnesota Probe

The governor has worked for years to crack down on fraud and ask the state legislature for more authority to take aggressive action. He has strengthened oversight including launching investigations into these specific facilities, one of which was already closed. They added that Walz has hired an outside firm to audit payments to high-risk programs, shut down the Housing Stabilization Services program entirely, announced a new statewide program integrity director, and supported criminal prosecutions.
US politics
fromNextgov.com
6 months ago

CMS launches 'chili cook-off competition' to source AI that can detect fraud

CMS announced the start of the "Crushing Fraud Chili Cook-Off Competition" on Aug. 19, calling it "a market-based research challenge" to identify emerging technologies that can "detect anomalies and trends in Medicare Fee-for-Service (FFS) claims data that can be translated into novel indicators of fraud." The agency said it is "prioritizing the use of innovative, data-driven approaches, including explainable AI/ML" that can analyze large datasets to "uncover unusual patterns, anomalies, or trends that may signal fraudulent activity."
Healthcare
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