CMS will use data analytics to help VA combat healthcare fraud

The Department of Veterans Affairs and the Centers for Medicare & Medicaid Services will join forces to share data and best practices on fraud prevention and detection. 

The partnership will allow the VA to take advantage of gains made by CMS in data analytics and fraud detection, the two agencies announced on Tuesday. 

The VA can "close existing gaps in its own claims payment process," by taking a look at what has worked for CMS, according to the announcement. 

The "alliance represents the latest example of VA's commitment to find partners to assist with identifying new and innovative ways to seek out fraud, waste and abuse," VA Secretary David Shulkin, M.D., said. The alignment, he noted, is part of a 10-point plan outlined by President Donald Trump that pushes the VA to better work with other federal agencies to detect fraud and abuse within Veterans Affairs. 

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Healthcare fraud prevention and detection has been a focus of the Trump administration thus far. Budget cuts proposed by the White House hit a number of healthcare agencies, but fraud enforcement instead got a boost in the budget drafts.  

The Department of Justice has said that healthcare fraud enforcement is a significant priority, and the agency launched a new program that uses data analytics to combat opioid fraud

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In addition to learning lessons from CMS, the VA invited industry experts to share new tools and techniques that it could use to improve fraud detection, according to the announcement. The VA plans to meet with those experts again in April, when they will demonstrate best practices and their capabilities for fraud detection and prevention. 

CMS established its Center for Program Integrity, aimed at reducing Medicare fraud, in 2010. The agency estimates that the center saved Medicare $17 billion in 2015, and CMS Administrator Seema Verma said in the announcement that it's crucial to share the lessons it's learned with groups like the VA. 

"We have a special obligation to keep America's promise to those who have served our country and ensure that veterans receive high-quality and accessible healthcare," Verma said.