Few States Use Data Mining Tools To Find Medicaid Fraud

Few states have taken advantage of a rule that allows state Medicaid fraud control units to use federal funding to pay for data mining tools that can help identify improper payments. Richard Stern, director of HHS' Office of the Inspector General Medicaid Fraud Policy and Oversight Division, said more Medicaid fraud control units should take advantage of data mining to reduce improper payments, especially those related to fraud. However, states are taking various approaches. For example, some state Medicaid fraud units -- including in California -- have applied and been granted permission to conduct data mining, while other states believe that their Medicaid agencies or health departments have sufficient data mining efforts.

• "HHS Wants More States To Data-Mine for Medicaid Fraud" (Dickson, Modern Healthcare, 12/16).