The CMS has awarded defense contractor Northrop Grumman Corp. a $91 million contract to develop and implement a second generation of an advanced analytics system, called the Fraud Prevention System, to help identify high-risk claims in Medicaid and Medicare.
The system is intended to capture and detect patterns and anomalies through the development of provider and beneficiary profiles in order to identify potential fraud, waste and abuse, according to federal contracting documents (PDF). Methods of detection will include scanning provider billing patterns and beneficiary utilization patterns.
The first version of the fraud prevention system, which was also developed by Northrop Grumman and launched in 2011, identified or prevented $820 million in inappropriate payments in the program's first three years, according to the CMS.
The second generation of the system will have new capabilities and a better user interface, according to the CMS.
Northrop Grumman did not respond to a request for comment.