Amida's graph-based approach transforms Medicare Fee-for-Service claims data into transparent, audit-ready indicators of potential fraud.

Amida Technology Solutions, Inc. (Amida), a software services company that solves the most complex challenges in data interoperability, data exchange, data governance, and data security, announced today it is a finalist in the Center for Medicare & Medicaid Services (CMS) Crushing Fraud Chili Cook-Off Competition. This market-based research challenge aims to harness explainable artificial intelligence (AI) – specifically machine learning (ML) models – to detect anomalies and trends in Medicare claims data that can be translated into novel indicators of fraud.

"We are absolutely thrilled CMS selected Amida as a finalist," shared Mukundan Srinivasan, CEO of Amida. "Every year, millions of dollars in fraudulent claims undermine Medicare's fiscal integrity and diverts critical resources from legitimate care delivery. With our platform, adjudicators would be able to take decisive action to identify potential fraudulent healthcare claims before they result in a payment."

Amida's proposed solution combines a novel graph embedding scheme with unsupervised clustering to expose systemic fraud networks, reduce false positives, and provide CMS reviewers with actionable evidence. It provides clear, defensible explainability for flagged anomalies, and it supports human oversight with visual dashboards and drill-down views. The solution operates securely and in full compliance with HIPAA and CMS Data Use Agreement requirements.

"Amida has an excellent track record with graph-based anomaly detection, including on health datasets at the Department of Veterans Affairs, and for cyber applications in national security," shared Peter L. Levin, Amida's Co-Founder and Executive Director. "Our technology can empower organizations like CMS to reduce improper payments, strengthen program integrity, and direct enforcement resources more effectively."

For more information on the CMS Crushing Fraud Chili Cook-Off Competition, visit https://www.cms.gov/priorities/crushing-fraud-waste-abuse/overview/crushing-fraud-chili-cook-competition.

About Amida

Amida Technology Solutions, Inc. delivers advanced data-engineering, AI/ML, and cybersecurity solutions that transform complex data into trusted, actionable insight. The company's platforms power systems for clients in healthcare, defense, and critical infrastructure.

www.amida.com

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