CMS recently released a long-delayed report on the first year results of its predictive modeling program, and while the report includes some positive results, questions remain over the accuracy of the numbers. According to the report, the predictive modeling program, also known as the fraud prevention system, helped stop or identify $115 million in fraudulent payments. However, an OIG report released Dec. 17 said there were inconsistencies in the report's data and in the methodology used to calculate the results. For example, the OIG said it could not determine the accuracy of $68 million in projected savings the report said were due to law enforcement referrals from the fraud prevention system, and CMS failed to include any numbers of actual recoveries made due the FPS.

The congressionally-mandated CMS report was due Oct. 1, and a bipartisan group of senators made repeated requests to CMS for information on the report up until its release. Julia Lawless, a  press secretary for the Republican staff of the Senate Finance Committee, told me that while the report appears promising, ranking member Orrin Hatch (R-Utah) will be taking a closer look to see if the numbers make sense.