(INDIANAPOLIS) - The Indiana Family and Social Services Administration is taking part in a 90-day pilot program that will use artificial intelligence to help prevent Medicaid fraud.
The Indiana Capital Chronicle reports the pilot was launched by the federal Centers for Medicare and Medicaid Services and gives Indiana free access to advanced AI software from Oracle.
The software will be used to analyze Medicaid claims for suspicious billing patterns, including upcoding and ghost services.
FSSA says the technology could help identify fraudulent claims before they are paid.
The agency also plans to test whether the software can suggest claims edits, prior authorization triggers and policy changes. It may also help create a shared platform for joint fraud investigations and faster enforcement actions against high-risk providers.
In exchange, Indiana FSSA will report to CMS on whether other states could use Oracle's models and software for Medicaid fraud detection. The state will also identify technical, legal and privacy issues that would need to be addressed before a broader rollout.
Gov. Mike Braun said Indiana is proud to partner with CMS and Oracle and said the effort is aimed at protecting taxpayer dollars while continuing to administer programs for low-income residents.
The Indiana Capital Chronicle reports the pilot is part of state and federal efforts to root out waste, fraud and abuse in Medicaid. One reason for the push is a new federal law that will reduce states' Medicaid matching rates based on error rates in the future.
In April, FSSA Secretary Mitch Roob said the agency was seeking to recover $200 million in alleged improper payments to attendant care providers after an audit of 625 Medicaid claims found errors in nearly all of them.
The agency also paused signups for autism behavioral analysis providers earlier this month while reviewing Medicaid claims for similar irregularities.