Prevention eliminates the potential for fraud, waste, and abuse before it begins through a process of disallowing improper claims on the front end.

Prevention includes:

• Education and outreach activities regarding such issues as eligibility and incentives.
• Periodic audits to deter inappropriate activity.
• Improve claims editing and operations controls through audits.
• Data Analysis to detect patterns or aberrations that may involve fraud or abuse, for the purpose of preventing inappropriate prospective or retrospective payments.