Voice Verification Technology Deployed to Prevent Abuse of Florida's Medicaid Services

In south Florida, where in-home health-care fraud runs rampant, the Florida Agency for Health Care Administration (AHCA) hopes to stem future scams and save money using voice verification technology.

Starting July 1, the agency, which administers Florida's Medicaid program, will launch a pilot project in Miami-Dade County using the technology to make sure assigned nurses or home health aides actually deliver services to Medicaid recipients.

Sandata Technologies, a New York-based software company, will implement the pilot program. The company will keep the recorded voices of all nurses and home health aides in a database. When the registered health-care providers arrive at a patient's house, they will dial a number, enter a code and speak an assigned message. The software will verify whether the voices match.

Florida's Telephonic Home Health Service Delivery Monitoring and Verification pilot mirrors similar efforts across the country aimed at using biometrics to prevent waste, fraud and abuse in social services programs. In March, for instance, California Gov. Arnold Schwarzenegger's administration announced plans to test devices that would scan fingerprints and snap photographs of disabled and elderly residents who receive in-home care.

Florida's pilot program stems from SB 1986. Passed by the Florida Legislature last year, the bill gave the AHCA authority to raise standards for home health-care providers in the state, including penalties and sanctions to help prevent fraud and abuse.

The bill also specifically authorized the agency to launch a management pilot in Miami-Dade County, which accounts for the bulk of Florida's spending on home health services. From 2006 to 2009, Miami-Dade County accounted for about 90 percent of Florida's Medicaid expenditures for home health aide visits. Of the 683 home health-care providers in the state who deliver Medicaid services, 55 percent are located in Miami-Dade even though only 19 percent of Medicaid recipients live there. The AHCA will report the results of the pilot to the Legislature, according to Tiffany Vause, the agency's press secretary. Depending on the pilot's success, she said, the program could be expanded.

Voice verification software for the in-home health-care market is relatively new, emerging within the past two years, according to Harold S. Blue, CEO for Sandata.

"It's sort of the next step of security," Blue said. "We've registered all nurses and nurse aides so now when they get to the person's house, with 99 percent accuracy, that person's voice is matched to biometric. We know it's not just a friend using the nurse's PIN code and dialing in the number."

According to the AHCA, Sandata will work with all home health agencies in Miami-Dade County to provide the following accountability measures:

• Confirm home health visits by receiving calls from home health agency personnel (nurses and home health aides) at the beginning and end of each home health visit using the Medicaid recipient's home telephone. For Medicaid recipients without a telephone, Sandata will use alternative methods to track the delivery of services.
• Generate claims for home health visits through its payer management system, and ensure that the service delivery information is consistent with the prior authorization in the Florida Medicaid Management Information System.
• Provide Web-based access to schedule visits, view a record of previous in-home services and confirm the accuracy of billing records before they are submitted to the agency's fiscal agent.