CMS, VA partner to combat medical fraud and abuse

The collaboration aims to improve the VA’s ability to investigate fraud and wrongdoing in Veterans Affairs programs.
By Jessica Davis
04:03 PM
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CMS, VA partnership

The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services and the Department of Veterans Affairs have partnered to share data, analytics and best practices to curtail the fraudulent claims paid by the agencies.

The partnership is designed to leverage CMS’ programs and tools and apply them to the VA’s programs. Under VA Secretary David Shulkin, MD, the VA has been working to modernize the agency and improve healthcare for veterans. President Trump has made the reform effort a top priority, vowing to investigate misconduct.

The program, according to a statement from Shulkin, will improve the agency’s ability to investigate fraud and wrongdoing in VA programs. Officials hope CMS’ background with integrity protocols will help the VA close gaps in claims payment processes.

[Also: DOJ recovered more than $3.7 billion from False Claims Act cases in 2017]

The announcement follows an RFI for details on fraud detection tools released by Shulkin earlier this month. In November, the VA spoke with industry experts to gain insights on the best fraud detection capabilities. The agency plans to hold a demo-day for these vendors to display their tools’ capabilities.

CMS established its Center for Program Integrity in 2010 to focus on fraudulent claims, which officials estimate saved the government about $17 billion in Fiscal Year 2015.

“CMS is sharing lessons learned and expertise to support VA to identify waste and fraud and eliminate these abuses of the public trust,” said CMS Administrator Seema Verma in a statement. “Using state-of-the-art data analytics, CMS is partnering with VA to better detect and prevent wrongdoing in its programs.”

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com