OIG Proposes to Allow Medicaid Fraud "Data Mining"

The HHS Office of Inspector General (OIG) has published a proposed rule that would end a current prohibition on State Medicaid Fraud Control Units (MFCU) using federal matching funds to identify fraud through screening and analyzing state Medicaid claims data – a practice known as "data mining." The OIG proposes topermit federal financial participation in the costs of defined data mining activities under specified conditions in an effort to "support and modernize MFCU efforts to effectively pursue Medicaid provider fraud." MFCUs would be required to annually report the costs and results of approved data mining activities. Comments will be accepted on the rule until May 16, 2011. 

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