New system to predict fraud and abuse

By Paula E. Hartman-Stein, Ph.D.
November 14, 2011

Due to increasing pressure to reduce fraud, abuse, and billing errors in its Medicare program, the Center for Medicare and Medicaid Services (CMS) announced on July 1 that Northrop Grumman Corporation, a global security firm known for its defense contract work, has been contracted to develop a predictive statistical modeling system to identify high-risk medical claims.

The contract is for $77 million over one year with three, one-year renewal option periods.