Texas to automate its fraud detection efforts
The State of Texas has commissioned Intelligent Technologies Corporation of Austin, TX, and HNC Software Inc. of San Diego, to develop an automated Medicaid Fraud and Abuse Detection System (MFADS) at a cost of $1.6 million.
According to the Texas State Comptroller's office, Texas stands to lose $1.7 billion to Medicaid fraud, abuse, and waste during the current budget cycle. State officials claim that an automated approach is well suited to the task of rapidly processing large quantities of claims data and selecting out suspicious transactions.
According to Intelligent Technologies, the MFADS system uses "neural networks" to analyze old Medicaid claims data and "learn" from it by identifying questionable patterns.
The HHS Office of the Inspector General and other federal investigators have applied the controversial practice of pattern detection to Medicare claims for several years.
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