Fraud, waste and abuse (FWA) continue to undermine the integrity of health and social service programs, diverting critical resources from those who need them most. In fiscal year 2023, the U.S. Department of Health and Human Services reported more than $100 billion in improper payments across Medicare, Medicaid and related programs. CGI Federal, in partnership with TrackLight and Amazon Web Services (AWS), is helping agencies modernize their approach to fraud prevention—shifting from reactive audits to proactive, AI-powered strategies that detect and prevent fraud in real time.
Our purpose-built FWA prevention platform combines machine learning, anomaly detection and advanced identity resolution to flag high-risk transactions, stop fraud at the point of entry and accelerate investigations. The solution integrates seamlessly with existing systems, enabling real-time data sharing and risk scoring. It also draws on linked background insights—such as financial and employment records—to build comprehensive fraud profiles and reduce false positives. This connected approach empowers agencies to act faster, reduce losses and protect public trust.
But technology alone isn’t enough. CGI supports agencies with policy alignment, staff training and change management to ensure successful adoption and long-term impact. Together with TrackLight’s behavioral analytics and AWS’s secure, scalable cloud infrastructure, we deliver a resilient ecosystem that evolves with emerging threats. By embracing this intelligent, end-to-end solution, agencies can strengthen program integrity, improve operational efficiency and restore confidence in the systems that serve our most vulnerable populations.
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