Healthcare program integrity
Fraud, waste and abuse (FWA) targets numerous sectors, but healthcare is particularly vulnerable due to the complexity of healthcare billing. Even honest mistakes can lead to improper payments and waste. Government health programs are committed to fighting FWA to preserve funds for citizen services.
CGI is a leader in healthcare claims audit and recovery and has extensive experience in building healthcare program integrity systems that foster transparency and deter fraud. This includes systems to enable federal health agencies to verify physician credentials prior to paying claims, reducing the risk of improper payments to fraudulent or unqualified providers, and to provide transparency in reporting financial transactions made by pharmaceutical, biologic and medical device manufacturers to physicians and teaching hospitals.
Blockchain offers a new paradigm for digital interaction and data exchange in federal programs that doesn’t rely upon a trusted third party to maintain a centralized record of transactions. Thus, it has the potential to help agencies assure the quality of goods in a supply chain and ensure the integrity and cryptographic security of data-driven records and services.
CGI has been at the forefront of financial services industry efforts to launch proofs of concept (POCs), and bring this expertise to assist the federal government as it shows keen interest in blockchain’s benefits of security, immutability, availability and transparency in addressing FWA, and more.