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Improving Medicaid Fraud, Waste, and Abuse Detection

Colorado Senate Bill 13-137, Act Concerning System Improvements to Prevent Fraud in the Medicaid Program, was signed by the Governor on May 24, 2013.  It stated the intent of the Legislature to “implement waste, fraud, and abuse detection, prevention, and recovery solutions to improve program integrity in the State’s Medicaid Program and create efficiency and cost savings through a shift from a retrospective ‘pay and chase’ model to a prospective prepayment model.”

 

On June 18, 2013, the Department of Health Care Policy and Financing (Department) initiated a Request for Information (RFI).  Responses were due on July 22, 2013.  The Department received seventeen (17) responses from vendors.  The following link provides a summary of the RFI responses and proposed next steps in the Department’s research.

 

RFI Summary Reponses  

 

The Department proposes to host a Vendor Fair in Mid-January 2014 through Mid-February 2014. This Vendor Fair will allow vendors to demonstrate products and discuss their solutions with the Department.  All vendors who submitted responses and those on our distribution list will be provided an opportunity to present their products and solutions to the Department. The following link provides dates and available time slots related to the Vendor Fair.

 

Predictive Analytics Vendor Fair Announcement

 

  • Vendors wishing to contact the Department regarding the Vendor Fair or joining the distribution list may contact Ying Moua at Ying.Moua@state.co.us.

 
  • The Department will discourage staff from attending meetings with individual vendors outside of the Vendor Fair to maintain the integrity of the process and any future RFPs related to this topic.