CMS saved $2 billion by using AI to fight fraud, official says

Centers for Medicare and Medicaid Services COO Kim Brandt talked about her agency’s use cases for artificial intelligence in the ongoing battle against fraudulent medical claims.

The Centers for Medicare and Medicaid Services has been able to save billions of dollars in less than a year by applying artificial intelligence to tackle duplicative contracts and fraudulent claims, according to Kim Brandt, deputy administrator and chief operating officer at CMS, who spoke at the Nextgov/FCW Fed Tech Priorities summit on Feb. 18.

She described the AI system as “a Netflix-type algorithm” that can pinpoint bad actors by using existing information to label an applicant as potentially “high risk” when submitting claims. Brandt clarified that the AI does not allow CMS to prohibit applicants from entering CMS programs, but instead allows them to be placed on an internal watch list for ongoing monitoring.

“Within the first year [of using AI ...