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Rule lets Medicaid fraud-control units tap federal funds for data-mining
Modern Healthcare

With states bracing for rapid enrollment growth in their Medicaid programs, HHS‘ inspector general’s office has given state-based fraud-control units more power to use sophisticated data-analysis tools to recover an estimated $60 million in the next decade. The final rule published Friday allows state Medicaid fraud control units to use federal funding to pay for data-mining in search of trends in claims data that could show patterns of fraudulent Medicaid billing.