CMS unveils new fraud-fighting center amid skepticism

BALTIMORE, July 31, 2012—The Centers for Medicare & Medicaid Services (CMS) unveiled its new fraud-fighting center to the press and dignitaries amid skepticism about how well the center will work and how much it cost.

The $3.6 million Program Integrity Command Center in Baltimore is equipped with a dozen computer workstations and a new $77 million computerized Fraud Prevention System (FPS).

Republican members of the Senate Finance Committee, which has been investigating the effectiveness of the government’s fraud-fighting efforts, said they needed more details on the computerized system for detecting fraud. They asked for performance metrics and how the system will target claims for review.

“After our offices saw a live demonstration of the FPS, we have concluded there is a significant disconnect between the rhetorical claims made by the administration and the system’s actual current operational status,” U.S. Sens. Orrin Hatch, R-Utah, ranking member of the Senate Finance Committee, and Tom Coburn,R-Okla., a committee member, wrote in a letter to CMS.

Critics of the system say that it employs a limited number of predictive analytic algorithms, or models, and it needs hundreds of models.

In a blog, Dr. Peter Budetti, CMS deputy administrator and director of the Center for Program Integrity, said the new facility will allow faster investigations and real-time monitoring of claims and payments.