Viewpoint
In the evolving landscape of health and social services, CGI is committed to transforming how organizations tackle fraud, waste, and abuse. With the new administration's focus on generating savings through efficiencies and reducing costs, we embrace innovative strategies and investments in AI and emerging technologies.
Our thought leadership in this area highlights the need for high-tech and impactful solutions to address the over $100 billion in estimated Medicare and Medicaid fraud and waste, where 8% of claims are improperly paid, leading to a $3 billion increase in improper payments in Medicare alone. By optimizing systems and processes, we aim to reduce operational costs and enhance the effectiveness of fraud prevention strategies, ensuring that resources are allocated efficiently and transparently.
Fraud, waste, and abuse (FWA) continue to drain critical resources from our nation’s health and social services programs. At CGI Federal, we help government agencies take a bold, modern approach to detecting and preventing FWA before it occurs.
Here’s how we’re addressing today’s most pressing challenges head-on:
Breaking down data silos and connecting the dots
Outdated, disconnected systems present opportunities for sophisticated fraudsters. Limited interoperability across programs like Medicaid, Medicare, and SNAP leaves critical gaps in detection efforts.
CGI Federal delivers integrated, interoperable solutions that break down barriers between systems and unlock real-time data sharing within and across agencies—empowering government to detect fraud faster, coordinate responses more effectively, and make informed policy and process changes that safeguard against future fraudulent activities.
Outsmarting evolving fraud with AI-powered precision
Fraud schemes are more sophisticated than ever, driven by AI, synthetic identities, and digital exploits. Traditional rule-based systems can’t keep up.
CGI Federal equips agencies with cutting-edge analytics and AI-driven threat detection, enabling them to adapt in real time, identify suspicious behavior earlier, and outmaneuver even the most complex schemes.
Expanding capacity without expanding budgets
Workforce shortages and tight resources shouldn’t limit an agency’s ability to fight fraud. Yet too often, they do.
CGI Federal partners with agencies to scale fraud prevention efforts efficiently, bringing the tools, expertise, and support needed to strengthen defenses and move from reactive to proactive fraud mitigation.
