The Center for Program Integrity (CPI) of the Centers for Medicare & Medicaid Services (CMS) has granted a five-year, $34.4 million API implementation contract that will improve data exchange for fraud detection. CMS’ Center for Program Integrity (CPI) has implemented an API to enable data exchange for better Medicare and Medicaid fraud detection.
- The contract: The contract with health IT provider CGI for its API Gateway product will result in a streamlined data exchange solution that will help CPI achieve its purpose of uncovering and combatting Medicare and Medicaid fraud, waste, and abuse.
- Access: Users of the health IT system, such as law enforcement officers and the Office of Inspector General (OIG), will be able to access and analyze real-time data in order to uncover Medicare and Medicaid fraud, waste, and abuse.
- Real-time data: “Implementing the API Gateway will enable real-time data sharing between Medicare and state Medicaid while reducing redundant screening checks and operational costs,” Steve Sousa, senior vice president of consulting services for CGI Federal, said in a public statement. “We are pleased to provide this solution and continue our long-standing partnership with CMS,” Sousa continued. “CGI is proud to contribute to the HHS/CMS team for API Life Cycle Management.”
- New rules: APIs are widely used in a variety of industries. An API is used when someone checks the weather on her phone, searches for a flight on a website, or sends a direct message. Simply said, an API is a program that delivers data back and forth between a user and a website or app. While healthcare has lagged behind other industries in terms of API use, new rules are encouraging more people to embrace health information technology.
- Effective exchange: “Patients have a right under HIPAA to access their health information,” CMS officials noted in a fact sheet. “We believe they also have a right to know their health information is exchanged in a way that ensures their privacy and security. We are working to balance these important issues in a way that empowers patients to be in charge of their healthcare.”