Medicaid Fraud and Abuse Detection System
Overview
Fit Score
Settle Intelligence
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SUMMARY
DESCRIPTION
The state of Indiana is seeking a vendor to provide a Medicaid fraud and abuse detection system. The proposed solution should utilize advanced analytics and data mining techniques to automatically identify potential instances of fraud, waste, and abuse within the Medicaid program. The system will support multi-tiered investigations and enable authorities to efficiently track and manage suspected cases.
The selected vendor will be responsible for the ongoing management and maintenance of the solution, ensuring availability and support 24 hours a day, seven days a week. Additionally, the vendor will be required to deliver comprehensive monthly reports to the Family and Social Services Administration (FSSA), including updates on detected cases, algorithm performance, and audit statuses. The contract for this engagement will span a period of two years.