AI-Powered Fraud, Waste, and Abuse (FWA) Analytics Platform Development

The contract seeks the design and implementation of a cloud-based artificial intelligence and machine learning system aimed at identifying fraudulent, wasteful, and abusive billing behaviors within Georgia’s Medicaid programs. The system must detect aberrant provider billing patterns, duplicate provider enrollments, and improper payments by analyzing vast volumes of claims and enrollment data. The solution must be scalable, secure, and integrated with existing state health infrastructure to enable real-time monitoring and automated alerts while ensuring compliance with healthcare data privacy standards. The project is issued as a subcontract under NAICS code 518210, indicating it falls under data processing and hosting services, and is managed by the Georgia Department of Community Health. Although specific performance locations and points of contact are not detailed, the work is expected to support state-level oversight of Medicaid expenditures. Proposals must be submitted by May 25, 2026, and the initiative reflects a strategic effort to enhance fraud detection capabilities using advanced analytics, ultimately improving fiscal integrity and operational efficiency across Medicaid services in Georgia.