(Photo by Samuel Nute / Cronkite News)
By Arizona Capitol Times
Key Points:
- Arizona Health Care Cost Containment System will use AI tool for prepayment claim review
- Hobbs announced the tool in response to a directive from the Centers for Medicare and Medicaid Services
- The governor says the state will revalidate “high-risk” Medicaid providers at CMS’ request
The Arizona Health Care Cost Containment System will start using an artificial intelligence tool to review payments to healthcare providers to prevent “fraud, waste and abuse,” according to Gov. Katie Hobbs.
In a letter sent to Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, Hobbs said the state plans to launch what it believes is the United States’ first “AI-informed Medicaid prepayment review system.” The governor’s letter came as a response to Oz’s April 23 directive instructing all 50 states to revalidate “high-risk providers” in their Medicaid programs.
“Arizona didn’t wait for Washington to call — we’ve been building and deploying the tools to fight Medicaid fraud since I took office …” Hobbs said in a statement. “Now, we’re building on this work and launching a first-of-its-kind AI system that will catch fraud before money goes out the door.”
