"We are honored to be recognized by CMS as a national finalist in the Crushing FWA Challenge," said Amber Nigam, Co-founder and CEO of Basys.ai. "Our mission is to make healthcare more accessible and affordable by pairing responsible generative AI with the clinical guardrails that matter most. This recognition reflects the strength of our platform, the trust of our partners, and the potential of AI to meaningfully reduce waste while improving care. Since its inception, Basys.ai has been supported by leaders from major health plans along with world-class physicians from institutions like Mayo Clinic. The company's strength lies in training its algorithms to minimize blindspots and reflect real-world clinical decision patterns."
CMS created the FWA Challenge to surface solutions capable of identifying high-risk patterns in medical claims and enabling earlier detection of improper payments. Basys.ai leveraged its multi-agent AI platform, Basys-INFER, to detect wasteful services and recommend mitigation strategies. These capabilities were also examined in a Harvard Business Review article highlighting how basys.ai's domain-aware, multi-agent approach enables earlier identification of wasteful patterns and more informed interventions.
Drawing on his personal journey as a caregiver and co-founder of basys.ai, an experience he has written about previously in STAT News following his father's illness, Nigam grounded his remarks in the real human cost of misaligned healthcare systems. Reflecting on themes from the TED talk he delivered nearly three years ago, he emphasized that healthcare has reached a tipping point where alignment of incentives is no longer optional. Amber highlighted the need to unify stakeholders around patient-centered outcomes, describing basys.ai as "the Swiss of healthcare," with trusted engagement across payers, providers, life sciences, and auditors. He further noted, "basys.ai's proprietary AI enables health plans to establish responsible and efficient guardrails that can be applied in Medicare settings to identify multiple forms of fraud, waste, and abuse."
The Basys-INFER model evaluates complete claim records, identifies signals of potential overutilization, and surfaces the most potent patterns along with clear next steps. This work aligns with CMS goals of enhancing accessibility, protecting beneficiaries, and ensuring that care remains affordable across Medicare Part B, DME, Hospice, and other high-impact categories. In addition, Basys.ai participates in national efforts such as the NCQA-driven AI Working Group focused on promoting ethical and accountable applications of AI.
Basys.ai presented its solution live to CMS, program integrity leaders, and federal stakeholders on December 9 at MITRE, located at 2275 Rolling Run Drive, Baltimore, MD, during the official finalist showcase.
Nigam concludes, "We see this as a once-in-a-generation opportunity to build trustworthy AI that improves access and protects the sustainability of Medicare for decades to come. We are grateful and honored to have brilliant partners and strong distribution supporting this mission."
About Basys.ai
Basys.ai, co-founded by a Harvard alumnus and CEO Amber Nigam, is an award-winning, agentic AI-powered prior authorization, utilization management, and medical review platform for health plans, providers, and federal organizations. The platform applies multi-agent AI models, advanced policy ingestion, and transparent clinical guardrails to automate complex healthcare workflows. Basys.ai has institutional investors and shareholders such as Mayo Clinic, Eli Lilly, and CareFirst.
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