A Medical Device Daily

The Centers for Medicare & Medicaid Services (CMS) has selected the healthcare business of Thomson Reuters (New York) to provide data analysis services to detect potential fraud and waste in Medicaid.

Thomson was awarded a task order to help identify inappropriate and unnecessary Medicaid payments pursuant to the federal Medicaid Integrity Program (MIP).

The MIP was created as a result of the federal Deficit Reduction Act of 2005, a law that became effective in 2006. Through the MIP, Congress specifically charged the U.S. Department of Health & Human Services with combating Medicaid provider fraud and waste through reviews and audits. CMS' Medicaid Integrity Group (Baltimore) is the component that oversees the MIP.

The task order was awarded to Thomson following a competitive procurement process. The task order covers the CMS' Atlanta Region, which includes Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. These eight states have approximately 9 million Medicaid recipients.

Thomson will analyze Medicaid claims data from the Atlanta Region in order to identify aberrant Medicaid billing patterns and providers that have submitted claims that have resulted in inappropriate Medicaid payments. CMS Medicaid Integrity Group then will have audit contractors conduct post-payment provider audits and, where appropriate, identify Medicaid overpayments.

U.S., Canada discuss mutual recognition

The chairmen of four Canadian securities regulators and the chairman of the U.S. Securities and Exchange Commission (SEC), following a series of meetings coinciding with the annual conference of the International Organization of Securities Commissions (IOSCO) in Paris, has reported a schedule for the completion of a process agreement that would open the way for discussions of a potential U.S.-Canada mutual recognition arrangement.

Canada has a system of securities regulation in which 13 separate provincial and territorial securities regulators administer and enforce highly harmonized laws and regulations. In order to facilitate discussions between Canada and the U.S. and more closely coordinate their systems of securities regulation, the SEC and the Canadian Securities Administrators (CSA) are working on an agreement setting forth the process to be followed in discussing mutual recognition arrangements.

The process agreement was scheduled to be concluded in mid-June.

Once concluded, it would open the way for substantive discussions between the CSA and the SEC on the subject of mutual recognition, which could provide Canadian securities exchanges and certain other Canadian financial service providers with greater freedom to operate in the U.S. under Canadian regulatory oversight, while U.S. securities markets and certain other U.S. financial service firms could gain greater freedom to operate in Canada under SEC oversight. Dual regulation, redundancy, and regulatory overlap could be eliminated.