Several weeks ago, South Carolina was the victim of what some experts believe to be the largest cyber-attack against a state tax department in history. Approximately 3.6 million personal South Carolina income tax returns were exposed, and nearly 657,000 businesses compromised, in an international hacking attack. Coincidentally, SAS and the SC
… and any fool will mind it”. ~ Henry David Thoreau. The EPA was in my neighborhood several weeks ago testing well water - never a good sign. It was determined that the subdivision just north and upstream of us had once been the site of a farm contaminated by
There's an interesting and relevant read in this month's issue of The Atlantic about a "data vigilante." Uri Simonsohn, a social psychologist, has been outing fraudulent research based on his re-inspection of the data in the published works. I've pulled a few facts from the article that are going to sound obvious
Recently, top executives from SAS gathered in Washington, DC with customers and other interested parties to discuss the potential impact of "big data" and high-performance analytics on the U.S. government. Topics included cyber-attack strategies, health care, bio-surveillance, border security and of course, fraud and improper payments. On the heels of
It has become more and more apparent, country by country and state by state, that many organizations do not have a clear grasp on what their exposure is to health care fraud. Whatever name it goes by – aberrant behavior, abuse, waste or fraud – and no matter how it is measured – in currency (dollars,
It is becoming clear that a fair percentage of the health care community, particularity outside of the United States, are uncomfortable using the word, “fraud.” Instead, you see the words "risk" and "error" used more often to describe fraud. There appear to be many different reasons for the discomfort with
Instances of cross-channel organized crimes and cyber-crime in banking, insurance and other sectors continue to rise across the globe. And, 2012 kicked off with the same, if not more momentum than 2011. Organized criminals are working harder than ever to keep the black market alive with ever-changing sophisticated crime schemes:
How do smart government organizations prevent fraud and improper payments? You might imagine they go after the bad guys one at a time - but technology is making it easier to identify networks of criminals with similar behaviors and even predict when certain behaviors are likely to start appearing. This fraud prevention
Fraud detection presents myriad analytical challenges: gathering sufficient known cases to make typical modeling techniques possible, gathering inputs from disparate data sources, and combining expert knowledge from investigators with findings to be gleaned from the data in an efficient way. Of course, analysts can fall into the trap of thinking
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
