Modernizing CMS Fraud, Waste & Abuse Analytics
How AGT strengthened CMS Program Integrity through advanced fraud analytics, business intelligence, and enterprise data solutions.
Centers for Medicare & Medicaid Services (CMS)
Fraud, Waste & Abuse (FWA) & Program Integrity
One Program Integrity (One PI)
Healthcare Analytics, Business Intelligence, Data Integration & Reporting
Trusted healthcare data, put in the hands of investigators
Protecting Medicare and Medicaid programs requires timely access to trusted data, advanced analytics, and secure investigative capabilities. AGT supported the Centers for Medicare & Medicaid Services (CMS) by enhancing the One Program Integrity (One PI) platform through enterprise analytics, business intelligence, reporting, and data integration solutions.
By improving access to healthcare data and analytical insights, AGT enabled investigators and program integrity teams to identify suspicious billing patterns, monitor potential fraud, and support informed decision-making across CMS operations.
National claims volume, evolving schemes, no room for downtime
CMS processes enormous volumes of healthcare claims, provider, beneficiary, and reference data every day. Investigators needed faster access to reliable information while managing increasingly sophisticated fraud schemes across Medicare and Medicaid programs.
The organization required a modern analytics environment capable of consolidating multiple data sources, improving reporting, supporting investigative workflows, and delivering secure access to mission-critical healthcare information without disrupting ongoing operations.
Enormous daily data volume
Claims, provider, beneficiary, and reference data arrive continuously at national scale and had to be consolidated before any meaningful analysis could begin.
Increasingly sophisticated schemes
Billing fraud patterns grew more complex and coordinated, requiring analytics that surface relationships and anomalies manual review would never catch.
Investigators waiting on data
Program integrity teams needed reliable information far faster than legacy reporting cycles could deliver it, which slowed case development.
Security without disruption
Sensitive healthcare information demanded protected, role appropriate access, and every enhancement had to land without interrupting ongoing CMS operations.
An analytics environment built around the investigative workflow
AGT combined healthcare data engineering with business intelligence and fraud analytics to strengthen the One PI platform and the program integrity work it supports.
Centralized healthcare data
Integrated healthcare claims and enterprise data into a centralized analytics environment.
Investigative dashboards
Developed executive dashboards and interactive reporting for fraud detection and investigative support.
Automated recurring reports
Automated recurring reports to improve operational efficiency and reduce manual effort.
Standardized data quality
Enhanced healthcare data quality through standardized integration and validation processes.
Billing anomaly analytics
Enabled advanced analytics for identifying billing anomalies, trends, and potential fraud patterns.
Secure investigative access
Improved investigative workflows through secure access to enterprise data and reporting.
Scalable analytics capability
Supported scalable analytics capabilities that continue to strengthen CMS Program Integrity initiatives.
Stronger detection, faster reporting, better decision support
The enhanced analytics environment changed how program integrity teams find, review, and act on potential fraud indicators.
Clearer fraud indicators
Improved visibility into Medicare and Medicaid fraud indicators.
Faster analytics access
Faster access to enterprise healthcare analytics and investigative reporting.
Less manual reporting
Reduced manual reporting through automated business intelligence solutions.
Sharper fraud detection
Enhanced fraud detection through advanced analytics and data visualization.
Consistent healthcare data
Improved consistency and quality of enterprise healthcare data.
Stronger Program Integrity
Strengthened Program Integrity operations through better decision support.
Greater transparency
Increased transparency across investigative and reporting processes.
Built to scale
Scalable analytics platform supporting evolving fraud detection initiatives.
From complex healthcare data to actionable insights that help protect Medicare and Medicaid programs.
Alliance Global Tech, Inc.
Healthcare analytics expertise built for federal missions
AGT delivers advanced healthcare analytics, business intelligence, and enterprise data solutions that help federal healthcare agencies strengthen Program Integrity and improve operational performance. Our expertise in healthcare data integration, fraud analytics, dashboard development, reporting modernization, and secure enterprise platforms enables agencies to make faster, data-driven decisions while protecting critical public healthcare programs.
Healthcare Analytics
Fraud Analytics
Business Intelligence
Enterprise Reporting
Data Integration
Dashboard Development
Secure Federal Solutions
Scalable Digital Platforms
Ready to strengthen your program integrity analytics?
Talk with AGT about healthcare data integration, fraud analytics, and reporting modernization for federal health programs.