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CMS Selects Thomson Reuters to Help Detect Medicaid Fraud in Eight States

ANN ARBOR, Mich., June 5 /PRNewswire-FirstCall/ -- The Centers for Medicare & Medicaid Services (CMS) has selected the Healthcare business of Thomson Reuters (formerly Thomson Healthcare) to provide data analysis services to detect potential fraud and waste in the Medicaid program.

Thomson Reuters was awarded a task order to help identify inappropriate and unnecessary Medicaid payments pursuant to the federal Medicaid Integrity Program (MIP).

The MIP was created as a result of the federal Deficit Reduction Act of 2005, a law that became effective in February 2006. Through the MIP, Congress specifically charged the U.S. Department of Health & Human Services with combating Medicaid provider fraud and waste through reviews and audits. CMS' Medicaid Integrity Group, in Baltimore, is the component that oversees the MIP.

The task order was awarded to Thomson Reuters following a competitive procurement process. The task order covers the CMS' Atlanta Region, which includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. These eight states have approximately 9 million Medicaid recipients.

Thomson Reuters will analyze Medicaid claims data from the Atlanta Region in order to identify aberrant Medicaid billing patterns and providers that have submitted claims that have resulted in inappropriate Medicaid payments. CMS Medicaid Integrity Group then will have audit contractors conduct post-payment provider audits and, where appropriate, identify Medicaid overpayments.

The Healthcare business of Thomson Reuters has extensive experience providing Medicaid decision support solutions -- including data management, mining, and analysis -- and using these capabilities to detect fraud and waste. The company currently supports 17 state Medicaid agencies, CMS' One Program Integrity, and other government programs.

"We are excited about providing our best-in-class data analysis capabilities to assist CMS with their program integrity activities," said Jon Newpol, Thomson Reuters executive vice president. "We are confident our abilities will help CMS meet their program objectives."

About Thomson Reuters

The Healthcare business of Thomson Reuters produces insights, information, benchmarks and analysis that enable organizations to manage costs, improve performance and enhance the quality of healthcare. Thomson Reuters is the world's leading source of intelligent information for businesses and professionals. We combine industry expertise with innovative technology to deliver critical information to leading decision makers in the financial, legal, tax and accounting, scientific, healthcare and media markets, powered by the world's most trusted news organization. With headquarters in New York and major operations in London and Eagan, Minnesota, Thomson Reuters employs more than 50,000 people in 93 countries. Thomson Reuters shares are listed on the New York Stock Exchange (NYSE: TRI); Toronto Stock Exchange (TSX: TRI); London Stock Exchange (LSE: TRIL); and Nasdaq (NASDAQ: TRIN). For more information, go to .

SOURCE Thomson Reuters
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