New Connecticut program targets medical fraud
Connecticut signed a three-year contract with 21CT, Inc. to provide anti-fraud technology that could save the state’s taxpayers $170 million, Gov. Dannel Malloy announced.
The new program is designed to stop fraud in state programs, including the Medical Assistance program, which is expected to see an increase in users because of the Affordable Care Act.
“We owe our residents and businesses the assurance that our programs have the integrity they demand, while dedicating resources to people who really need them,” Malloy said. “Whether beneficiaries or providers, people who defraud Medicaid are engaging in criminal activity. They should be caught and prosecuted. We will work diligently to recoup what they stole.”
The state budget anticipates $65 million in recoveries and cost avoidance from the anti-fraud effort this year, and $104 million next year.
It is anticipated that over time, additional state agencies and their data will be added to this initiative with a resultant expansion of the scope of work.
As Connecticut spends billions of dollars for health care services through Medicaid, Malloy, the state’s Office of Policy and Management and DSS have made the reduction of fraud a priority. The initiative is part of the state budget negotiated with, and passed by, the General Assembly earlier this year.
OPM Secretary Ben Barnes added massive data sets and ever-changing fraud schemes make it extremely challenging for state agencies to keep up with this work on its own, but he hopes the contract signed will alleviate these concerns.