On Tuesday, July 12, 2011, Lewis Morris, Chief Counsel to the Inspector General of the U.S. Department of Health & Human Services testified before the United States Senate Committee on Homeland Security & Governmental Affairs, Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security about the role new technologies can play in cutting waste and fraud in the Federal health care programs.
His testimony began:
“Program integrity efforts are enhanced by new information technologies and benefit from collaboration with the private sector, especially health insurers with whom we share investigative techniques and intelligence. My testimony provides several examples of how advanced data analytics are helping us conduct risk assessments, more effectively pinpoint our oversight efforts, and significantly reduce the time and resources required for audits, investigations, and other program integrity activities.
However, technology is not a silver bullet, and now more than ever, experienced professionals are integral to protecting Medicare and Medicaid. It is also important to be mindful that as program integrity efforts become more technology driven, so will health care fraud and we must adapt to this evolving environment. Additionally even the best fraud prevention technologies will be of little value if not effectively implemented and appropriately overseen.
New Technologies Hold Tremendous Potential for Enhancing Our Fraud Fighting Efforts
OIG is using information technologies and analytics, including data mining, trend evaluation, and modeling, to better identify fraud vulnerabilities and target our oversight efforts. OIG is leveraging an analytical foundation that provides an enterprise view of questionable activities, suspected fraud trends, and prevention opportunities. When united with the expertise of our agents, auditors, and program evaluators, OIG brings a formidable combination of cutting edge techniques and traditional investigative skills to the fight against fraud, waste, and abuse.