From “Pay and Chase” to “Catch and Keep:” CMS to Introduce Anti-Fraud Predictive Modeling July 1

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On June 17, Secretary of Health and Human Services Kathleen Sebelius announced in a speech in Philadelphia, Pennsylvania that the Centers for Medicare and Medicaid Services (“CMS”) will begin using an electronic predictive modeling program in the fight against health care fraud and abuse. While CMS uses various measures to combat fraud after the fact, this program is designed to identify fraudulent claims prior to payment. The program is set to kick off on July 1.

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