HHS launches AI initiative to detect fraud and waste in federal health programmes
The Department of Health and Human Services is moving from “pay and chase” to real-time AI screening across Medicare, Medicaid, CHIP and the Marketplace.
The US Department of Health and Human Services has launched an artificial intelligence initiative aimed at detecting fraud and waste across federal health programmes, building on a strategy first outlined in February that promises to replace the federal “pay and chase” model with real-time screening of claims before they are paid. Reuters reported the development on Wednesday.
The programme covers Medicare, Medicaid, the Children’s Health Insurance Programme and the Health Insurance Marketplace, according to the joint HHS announcement from earlier this year.
In that February rollout, HHS Secretary Robert F. Kennedy Jr, Vice President JD Vance and CMS Administrator Mehmet Oz framed the shift as moving from a decades-old approach of paying claims first and investigating later to what the agency calls a “detect and deploy”...
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