SOURCE: S3 Matching Technologies

July 15, 2008 06:00 ET

New Medicare Fraud Prevention Steps Considered Inadequate

Government Standards Ought to Equal Those of Private Business

AUSTIN, TX--(Marketwire - July 15, 2008) - Six years after identifying and promising to fix a multi-million dollar fraud problem in Medicare, the Centers for Medicare and Medicaid Services (CMS) has paid out $92 million dollars to dead doctors and medical equipment providers without developing an adequate technological fix to end the corruption. Medicare officials told the Senate Homeland Security and Governmental Affairs Investigations Subcommittee that they have come up with a new method of identification for doctors, and that qualified providers' names will be matched against Social Security death indices to make sure no fraudulent payments are going to phony health care companies.

"This is an important first step," said Jack Holt, CEO of S3 Matching Technologies. "But CMS is talking about running matches every 90 days. That would never be acceptable in the private sector and it ought not to be tolerated by taxpayers. Technology exists that can automatically run detailed matches of this nature on a daily basis."

Holt, whose company uses its own proprietary software to cleanse, compare, and update vast databases for some of the world's largest corporations as well as Medicare and Medicaid providers, pointed out that a 30 to 90 day window between matches still leaves a large opportunity for fraud.

"The government and the health care industry is slowly beginning to confront its challenges with data," said Andi Gillentine, Vice President for Healthcare at S3 Matching Technologies. "But simply changing doctor and provider identification techniques and running quarterly matches against bad databases are not going to eliminate fraud."

CMS has adopted new accreditation and qualification requirements for Medicare durable equipment providers and expects the new rigorous financial qualifying standards to reduce fraud.

"The government's standards on data need to be more rigorous," Holt added. "We're all taxpayers and I'm sure we'd rather pay for quality matching technology than non-existent wheelchairs or invisible oxygen tanks."

About S3 Matching Technologies (www.S3.com)

S3 is an Austin, Texas based company focused on providing data quality management software for the IT, telecom, financial services, and healthcare industries. S3 invented TeraMatch®, an algorithmic matching engine which uses rules-based scoring based on industry-specific best practices. S3's software may be deployed as a managed solution.

Contact Information

  • CONTACT:
    S3 Matching Technologies
    James Moore
    Email Contact
    512.300.9232