Rule to Enable Medicaid Data Mining for Fraud

The Department of Health and Human Services on March 17 will publish a proposed rule enabling federal funds to be used for state Medicaid fraud control units to conduct mining of their states' Medicaid claims data.

The rule, from the HHS Office of Inspector General, amends current regulations that prohibit use of federal matching funds for data mining. Fraud units currently rely on referrals from state agencies, providers and private citizens to identify possible cases of fraud.

The proposed rule, with a 60-day comment period, is available here.

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