Ohio Launches Additional Anti-Fraud Initiative With A New Medicaid Data Intelligence Platform

The Ohio Department of Medicaid (ODM) has added a fraud detection and analytics platform to strengthen program integrity. The platform, which received an award from the Centers for Medicare & Medicaid Services (CMS), was approved by the Ohio Controlling Board through an amendment to ODM's existing contract with Milliman, Inc.

ODM will use Milliman's Healthcare Anomaly Detection Platform. The platform uses predictive modeling, analytics, and risk scoring to help ODM identify potential fraud, waste, and abuse. The platform explains risk in plain language, identifies provider organization networks that may be coordinating, and generates evidence packages for use by . . .