CHA News Article

CMS Prevents $210M in Improper Payments With Fraud Prevention System

The Centers for Medicare & Medicaid Services (CMS) released a report this week on the second year of its Fraud Prevention System (FPS), finding that it identified or prevented more than $210 million in improper Medicare payments. The FPS uses predictive algorithms and other sophisticated analytics to analyze billing patterns against every Medicare fee-for-service claim. CMS currently has pilot projects underway to explore the expanded use of the FPS — beyond its initial focus on identifying potential fraud — into the areas of waste and abuse, including a system that would provide leads to Medicare Administrative Contractors for early intervention. The full report is available at