Business units of telecommunications services provider Verizon, New York, and health insurance giant WellPoint, Indianapolis, in a partnership with defense and national security contractor Northrop Grumman, McLean, Va., are working on a federal contract to help the CMS in the electronic fight against Medicare and Medicaid fraud, the three companies have announced.
Verizon, Wellpoint team up with Northrop Grumman
Federal Network Systems, Herndon, Va., the Verizon unit, will supply the CMS with a customized version of its predictive modeling technology used to detect fraud and protect security in its telecommunications network, according to a Verizon news release.
National Government Services, the WellPoint subsidiary also based in Indianapolis, will provide its expertise in fee-for service claims handling, including algorithms for fraud prevention as well as hosting of information technology and infrastructure, a Wellpoint statement said.
Northrop Grumman, the previously announced prime contractor, will “design, develop and implement a system that uses analytic approaches to generate alerts and evaluate results to identify and help prevent improper payments, fraud and abuse,” its statement said.
The “predictive modeling development” task order was awarded by the CMS under an Enterprise System Development indefinite delivery, indefinite quantity contract. The $77 million, one-year contract has three one-year option periods, the Northrop Grumman statement said.
"This critical program will help prevent the misuse of taxpayer dollars that can result from waste, fraud and abuse of the Medicare program, which will in turn decrease healthcare costs," Amy Caro, vice president of health information technology programs at Northrop Grumman, said in its news release. "Our uniquely qualified team will implement proven solutions and industry best practices that will help prevent fraudulent transactions before they occur, rather than identify fraudulent activity after the fact."
New computer-assisted fraud-fighting systems are expected to save the federal government as much as $21 billion over 10 years, but the CMS came under fire last week by the Government Accountability Office for foot dragging on the implementation of the anti-fraud initiatives.
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