IBM Fraud & Abuse Management System to Help North Carolina Spot Medicaid Fraud, Abuse & Waste

OPEN MINDS Weekly News Wire Strategic Health Care News On March 24, 2010, the North Carolina Department of Health and Human Services (DHHS), Division of Medical Assistance (DMA) launched a high-tech Medicaid fraud detection program accompanied by other measures to prevent fraud, waste and abusive billing. DHHS will use IBM Corporation’s Fraud and Abuse Management System (FAMS) to review electronic billing data for services provided to Medicaid beneficiaries, flagging claims with suspicious trends or anomalies common to abuse or fraud for further review by DMA Program Integrity investigators. IBM will earn 10% of all funds DHHS recovers—up . . .