“Enforcement actions carried out by the Centers for Medicare & Medicaid Services (CMS) have stopped over $1.6 billion in potentially improper Medicare lab payments so far under the Trump administration,” an Epoch Times report authored by Naveen Athrappully begins.
The CMS says that “$732 million was saved by revoking 157 fraudulent lab providers from the Medicare program. . . .”
That seems not insignificant.
In March last year, CMS launched its Fraud Defense Operations Center (FDOC), which has become a key tool to combat fraud, waste, and abuse in Medicare, according to the agency.
FDOC assembles investigators, data analysts, health policy experts, law enforcement, and legal advisors to crack down on fraud. It uses data-driven intelligence to detect threats in real time and shut down inappropriate Medicare billing, CMS said.
In its latest statement, CMS attributed the savings generated from the crackdown on fraudulent Medicare payments to advanced tools, such as machine learning and artificial intelligence. These tools look for indicators such as unusual billing patterns to identify potential fraud, abuse, and waste.
Hotbeds of fraud are the states of Minnesota and California — something readers of this website already knew: Paul Jacob has reported on several major cases in the past year.
Further, Minnesota Governor Tim Walz objects to the money not sent to his state because of the patterns of fraud detected.
Make of that what you will.