Report: Systems to Catch Medicaid Fraud Inadequate

The Associated Press reports:

The federal government's systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underused, making it more difficult to detect the billions of dollars in fraudulent claims paid out each year, according to a report released Tuesday.

The Government Accountability Office report said the systems don't even include Medicaid data. Furthermore, 639 analysts were supposed to have been trained to use the system — yet only 41 have been so far, it said.

The Centers for Medicare and Medicaid Services — which administer the taxpayer-funded health care programs for the elderly, poor and disabled — lacks plans to finish the systems projected to save $21 billion. The technology is crucial to making a dent in the $60 billion to $90 billion in fraudulent claims paid out each year.

"I'm looking forward to hearing, someday, about major fraud scams discovered as a direct result of this integrated repository and the use of creative pattern recognition techniques implemented on top of it. Until we hear that story, the public is not getting value for money from these investments," said Malcolm Sparrow, a health care fraud expert at Harvard University.