Texas nearing $90M deal on Medicaid fraud detection software

The Texas agency charged with investigating Medicaid fraud is finalizing a $90 million contract for Medicaid fraud detection software.

Federal officials recently approved $67.5 million in matching funds to pay for three years of software licenses and services from the company, 21CT, according to a statesman.com story.

Austin-based 21CT is a federal defense contractor that had no experience with Medicaid before 2012, when the company was asked to use its Torch software to analyze a massive amount of data associated with $28.3 billion in Medicaid spending, according to a KVUE.com story.

The Texas Health and Human Services Commission Office of Inspector General (OIG) has been criticized for collecting only $5.5 million in the last year following a Texas Sunset Commission staff report that cited hundreds of millions of dollars of Medicaid fraud.

The Sunset Commission report found that Torch software had identified only $41 million in Medicaid fraud for 2014, according to a Texas Dentists for Medicaid Reform story.

Texas has been rocked by allegations of fraud by dentists and orthodontists accused of bilking the state Medicaid program out of tens of millions of dollars. An OIG investigation found $6 billion in fraud and waste within Medicaid from 2004 to 2011.

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