It's easy to get distracted by new developments in the fight against healthcare fraud. New services. New providers. Relaxation of rules. The COVID-19 pandemic has quickly revolutionized the healthcare landscape. For instance, the government made sweeping regulatory changes to accommodate a surge in patients. Healthcare delivery and payment organizations, commercial
With tax week quickly approaching, tax agencies have been issuing press releases alerting the public they’re holding tax refunds for review longer than in years past. This is a departure for tax agencies. Tax agencies have traditionally lived and died by refund cycle time. Refund cycle time, or getting refunds
When it comes to fraud detection and risk mitigation, predictive modeling has earned a reputation as the “heavy hitter” in the realm of data analytics. As our celebration of International Fraud Awareness Week continues, I would challenge our readers to ask themselves this question, “Is the reliance upon predictive analytics
Another day, another scam defrauding insurers and governments. For purposes of full disclosure, the case I'm highlighting today comes from Washington's Labor and Industries (L&I), the agency where I formerly worked and headed up fraud prevention efforts, and the investigation dates back to my time there. During my time there,
Sometimes, it is good to start with a confession. I filed my taxes at the last minute. It was past time to get some money back from the IRS before they could waste $60,000 on another Star Trek spoof video. Normally I'm one of those people that files in February,
Personally, I love studies. They help put things into context, and when done well, provide an independent and hopefully unbiased view of the forces that shape our lives. They are also a great way to see government funds used in strange ways. For example, the new NIOSH (National Institute for
The first step is to answer the question of what “real-time” actually means. Depending on the program and industry speed of response, I’ve heard answers that varied from milliseconds for the biggest banks in processing credit card charges to 24 hours for some government programs. A better description of what
