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Centers for Medicare & Medicaid Services (CMS) have created a Fraud Prevention System (FPS) defined as using state-of-the-art predictive analytics technology. Since 2011, CMS has spent $182M in implementation costs, with over $1.5B identified (through 2015) as improper and potentially fraudulent payments. Can more be done? Certainly. Absolutely. A new breed of advanced analytical systems, such as DataWalk, help deliver more insights using a hybrid approach.
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