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CMS Selects Thomson Reuters to Help Detect Medicaid Fraud in Eight States
Date:6/5/2008

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 as
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SOURCE Thomson Reuters
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