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Medicaid Waivers

Ability of the Secretary of Health and Human Services to allow a state to continue obtaining Medicaid funds when it is no longer compliant with requirements of Medicaid statute. States seek Medicaid waivers when experimenting with innovative services and payment reforms.

Fraud Prevention Systems (FPS)

A system used to analyze Medicare claims to detect fraudulent behavior with the goal of preventing improper payments rather than having to collect them after…