CMS to teach VA new tricks in fighting waste and abuse

The Centers for Medicare and Medicaid Services and the Veterans Administration will share among each other data, data analytics tools and best practices for fighting fraud, waste and abuse.

CMS is further along in its fraud programs, particularly with analytics, and the VA will learn from the agency while also supplying data that may be new and useful to CMS.

The alliance is an example of VA’s commitment to find partners to help in identifying new ways to seek out fraud and waste to ensure every dollar supports veterans, says VA Secretary David Shulkin, MD.



CMS in 2010 established the Center for Program Integrity to combat fraud, waste and abuse, and in fiscal 2015 saved $17 billion in Medicare operational costs.

Also See: OIG: Medicare fraud prevention system needs improvement

Now, VA wants to capitalize on CMS’ experience where it has concentrated on use of advanced technologies, statistics and data analytics to improve fraud detection and prevention initiatives.

“CMS is sharing lessons learned and expertise to support VA to identify waste and fraud and eliminate these abuses of the public trust,” says Seema Verma, CMS’ administrator.

This past November, the VA sought out industry experts to learn about the newest tools and techniques to combat fraud. In April, the experts will demonstrate tools for detection of abuse and recovering improper payments. Among other benefits, the VA hopes using CMS protocols will help close gaps in its claims payment processes.