New York Medicaid oversight office to use data-mining visualization

In an effort to stop some of the financial bleeding in the state Medicaid system, the New York State Office of the Medicaid Inspector General (OMIG) has partnered with Salient Management to help eliminate fraud, waste and abuse, the company announced last week.

According to an audit from New York State Comptroller Thomas DiNapoli last month, “improper payments, billing errors and poor recordkeeping” had cost the state over $90 million in the last five years. Problems stemmed mainly from fraudulent billing and reimbursement payments, including a computer glitch that caused 26,000 recipients to have two Medicaid identification numbers. But abuse was also reported in less direct ways, such as transportation programs.

OMIG is looking to use Salient’s solution to help reveal these connections, and make cases of abuse and fraud standout.

Salient will provide an interactive visual data mining system that will help OMIG identify waste and abuse within Medicaid, but the solution will also help the Office get a better understanding of program accounting, cost containment and cost avoidance strategies. Data based on Medicaid providers, recipients, pharmacies and others will be combined in the data-mining visualization solution, the company said.

“The solution will help identify and investigate specific root causes, resulting in the identification of opportunities for improving outcomes and cutting costs,” the company said in a release.

According to a report by the Corning Leader, Salient technology is currently in use in Chemung County, where officials say the solution has potential to save the state billions.

“We think you could save billions of dollars,” Chemung County Deputy Executive Mike Krusen told the Leader. “It’s clearly hundreds of millions, but probably billions. We think there’s tremendous savings possible.”

The solution is already being used by a dozen New York counties, including Albany, Nassau, Westchester and others, which has laid the groundwork for the OMIG system, Salient CEO, Guy Amisano, said.

“Our work with New York counties, and now with OMIG, has established a platform that provides a modern and necessary capability to provide comprehensive oversight of Medicaid — both for New York and for any state entity with a mission to ensure program integrity and better manage the Medicaid population.”

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