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State aims to detect fraudulent Medicaid claims before they are paid

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The state has contracted with a technology company to create a modeling system aimed at detecting Medicaid fraud as it happens. Dynamics Research Corp., a publicly-traded company headquartered in Andover, has been awarded a one-year contract for $2.5 million to develop a system that tracks Medicaid claims filed to the state by hospitals and providers, looking for patterns that could indicate fraud.

Claims would be scored and those considered high risk flagged for follow-up. Chief Executive Jim Reagan said in a press release that the system could reduce the time needed to investigate cases of fraud. “Fraudulent Medicaid claims add unwarranted cost to the health care system and can potentially expose patients to increased health risks,” Reagan said.

Funded in part with federal money, the analytics system would be the state’s first to detect fraud before payments are made to providers, a MassHealth spokesman said.

Chelsea Conaboy can be reached at Follow her on Twitter @cconaboy.
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