The Department of Health and Human Services has fallen behind in developing a key fraud-fighting technology, Secretary Kathleen Sebelius admitted in a budget testimony before the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies yesterday.
The agency received $110 million in last year's budget for a two-year IT initiative that would build "predictive modeling" capabilities into Medicare's payment systems.
The idea: To develop preventive tools like those credit card companies use to red-flag unusual purchases or patterns of behavior. Sebelius termed it moving from a "pay-and-chase" payment model to one where payments are suspended when potential fraud is suspected.
Sebelius says the database is in development, but acknowledges that it likely will not be finished by its 2011 year-end deadline. "We've been a little bit frozen in our ability to move forward," she told senators yesterday, blaming budget problems. She didn't specify how long the delays will last, or when the project will actually conclude.
For more:
- watch the Senate Appropriations Subcommittee hearing