What is the purpose of the Fraud Prevention System (FPS) established in 2011?

The Fraud Prevention System (FPS), established in 2011, is specifically designed to analyze Medicare fee-for-service claims to detect potential fraud. By leveraging advanced analytics and data mining techniques, the FPS examines claims data for irregularities that may indicate fraudulent billing practices. This proactive approach allows for early detection and prevention of fraudulent activities, ultimately protecting the integrity of the Medicare program and ensuring that resources are used appropriately.

The focus on analyzing claims is pivotal, as it serves as a mechanism to safeguard against financial losses due to fraud and abuse. This systematic review not only enhances the efficiency of fraud detection but also helps maintain the trust of beneficiaries in the Medicare system. Other options, such as streamlining reimbursement processes or enhancing provider recruitment, do not align with the primary objective of the FPS, which is centered on fraud detection and prevention. Improving patient satisfaction scores is also outside the scope of the FPS’s intended use, which is primarily analytical and compliance-oriented.