What happens when a health care fraud scheme changes its spots?

Ross Kaplan
Ross Kaplan|February 22, 2012

In most of the articles and press pieces that speak of health care fraud, the topic is usually covered in broad terms regarding the type or activity that has taken place: over-billing to Medicare/Medicaid, services billed and not delivered, over subscription of medication (by members or Pharmacies), and the list [...]

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What's your grade? Utility Summit exposes wide gaps in analytical maturity

Alyssa Farrell
Alyssa Farrell|February 20, 2012

Managing the deluge of smart grid data. Responding to the increased demand for customer intelligence. Implementing analytics for grid optimization. These were just a few of the topics covered at this week’s inaugural “Utility Analytics Summit.” Utilities have been grappling with implementation of smart grid devices for several years and [...]

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Resolutions for the UK insurance industry in 2012

Martyn Kyle
Martyn Kyle|January 31, 2012

After all the Christmas parties and new year dinners are over, many would like to forget embarrassing behavior or over-indulgences of the season. By way of putting all that behind, it’s not uncommon for most to start the year by embracing a sober regime, diet and even a few New [...]

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Doesn’t everyone use an anti-money laundering solution?

David Park
David Park|September 21, 2011

Recently I had the privilege to attend two customer events hosted at SAS’ new Executive Briefing Center. The first was a two-day SAS anti-money laundering (AML) customer connections workgroup which was then followed by the 7th Annual Terrorism Financing and Money Laundering Forum. Some of you may be thinking, “Isn’t anti-money [...]

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Partnering to fight financial crimes

Waynette Tubbs
Waynette Tubbs|September 16, 2011

“Viewed by law enforcement, there is no line between money laundering and fraud; the distinction is the underlying activity.” That was Dan Wager’s opening remark to his discussion of fraud convergence during the 7th Annual Terrorism Financing and Money Laundering Forum hosted in Cary, North Carolina. Wager is Senior Vice [...]

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Emerging trends in fraud

Waynette Tubbs
Waynette Tubbs|September 15, 2011

One of the hottest topics on today’s agenda for financial institutions is FFIEC’s recently released guidance supplement calling for layered fraud secuity and authentication. So, during the recent Terrorism Financing and Money Laundering Forum in Cary, North Carolina, a panel discussion on fraud was developed to discuss emerging trends in fraud – [...]

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Trends in money laundering

Bill Abbate
Bill Abbate|September 14, 2011

New for this year’s Annual Terrorism Financing and Money Laundering Forum, the afternoon sessions were divided into two tracks, anti-money laundering (AML) and fraud, each featuring a topical presentation and a panel discussion. During the AML panel discussion on emerging trends, representatives from several US law enforcement agencies and the [...]

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Working together to fight terrorism and fraud

Bill Abbate
Bill Abbate|September 13, 2011

Sunday marked 10 years since the Sept. 11 terrorist attacks forever changed our focus on threats to US security. Last week, SAS hosted the 7th annual Terrorism Financing and Money Laundering Forum, a day of information sharing among the key players from both the public and private sectors in the [...]

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The value of outside information

Ross Kaplan
Ross Kaplan|August 29, 2011

Most health care organizations either intentionally or due to some inability don’t use outside information (not just referals) in their search for fraud.  There are great numbers of valid reasons for this: HIPAA, security, usable/current data sources, inflexible information systems or processes, restrictive compliance & IT departments, and the list [...]

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Mastering fraud and the 'perfect storm'

Stu Bradley
Stu Bradley|August 5, 2011

As a follow-up to my appearance on CNBC’s, The Call July 22, I feel it is appropriate to comment further on the fraud risks we are seeing across industries due to the continued move online. Karen Tso did a nice job of raising the significant cyber-crime issues we see due to [...]

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