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Better Tech Tools Help Slice Medicare Fraud

September 23, 2011

LANSING, Mich. - Over $4 billion: that's the amount of money recovered last year in false billings and fraudulent amounts charged to Medicare.

John Hammarlund, a regional administrator for Centers for Medicare and Medicaid Services, says that, thanks to the Affordable Care Act, there are new ways of detecting fraud.

"We now are employing very sophisticated computer-based tools, predictive analytics, pattern modeling, etc. The sort of computer tools that credit card companies use, for example."

The computer analytics, according to Hammarlund, allow them to find fraud in many more instances.

"We can detect some of these things that just simply can't be. You can't have one patient receiving the same medical procedure in two different cities at the same time."

He says the Affordable Care Act has allowed the Centers for Medicare and Medicaid Services to use new technologies to ferret out fraud, ultimately saving taxpayers billions of dollars.

Hammarlund says Medicare recipients can also help control fraud by looking over their statements and reporting any discrepancies to 1-800-MEDICARE.


Mona Shand, Public News Service - MI