FWA Insights & New Approach: State of Missouri, Medicaid Audit and Compliance Team
PREPARED BY:
Steven Goldberg, MD, MBA
This market report showcases how Missouri Medicaid Audit & Compliance (MMAC) revolutionized its fraud detection strategy using AI-powered analytics. Serving 1.3 million residents and managing over $13 billion in medical benefits and $2 billion in pharmacy benefits annually, MMAC implemented FWA Finder™ to tackle rising costs and improve fraud detection.
The platform identified 23,327 actionable leads (15,480 retrospective and 7,847 new), reviewed almost 150 unique FWA scenarios, and achieved $2.2 million in recoveries in a single month—yielding an extrapolated ROI of $50:$1.
Learn how Alivia’s comprehensive solution integrates advanced AI algorithms, real-time data analysis, and customizable queries to detect complex fraud patterns, reduce improper payments, and ensure compliance across provider types, facilities, and service types.
Products: Alivia FWA Finder™ and Alivia Case Manager™