Tag: fraud week

Analytics | Fraud & Security Intelligence
Mike Pflug 0
What do identity thieves covet the most?

Recently nine pharmacists from across the country were charged for their part in a $12.1M health care fraud scheme. The pharmacists allegedly took money for prescription medications that were neither purchased nor dispensed. The indictments further allege that the defendants billed Medicare and Medicaid for medications that were often medically unnecessary and for some medications that were purportedly dispensed to

Analytics | Fraud & Security Intelligence
Tom Wriggins 0
COVID opens door to pervasive healthcare fraud

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

Analytics | Fraud & Security Intelligence
Jen Dunham 0
Fighting bribery and corruption with supplier integrity

Bribery and corruption continue to plague governments and organizations around the world. Brazil’s Operation Car Wash, the 1MDB scandal in Malaysia, the FIFA bribery case and many others continue to make headlines. The prevalence of widespread, coordinated corruption and bribery is alarming and seems to continue to grow, despite ongoing sanctions and fines meant to deter these

Analytics | Fraud & Security Intelligence
Timo Kettunen 0
Adding insult to injury: Workplace safety and fraud

If a cinderblock falls from the 4th floor of a building and crushes a construction worker’s foot, it’s terrible. If it lands on his head, it’s truly tragic. But the difference is sheer luck.  Every employee deserves to return home safely from work. Unfortunately, accidents happen, which is why employers must carry mandatory workers’ compensation

Analytics | Data Management | Fraud & Security Intelligence
John Stultz 0
US government, analytics researchers step up fight against improper payments

  Improper payments continue to plague the federal government, though many actions are in motion to help turn the tide. The Trump Administration’s Building a Better America: A Plan for Fiscal Responsibility, released in July 2017, emphasizes reducing improper payments, currently estimated by the Government Accountability Office (GAO) to total

Analytics | Artificial Intelligence | Fraud & Security Intelligence | Machine Learning
Jen Dunham 0
Considering fraud-fighting with machine learning and artificial intelligence?

Any look back at analytics in 2017 makes it clear that machine learning and artificial intelligence appear to be the ‘next big things’ that can solve just about any problem, from writing new hit songs to curing disease. Not one to buy into the hype, I became curious as to

Analytics | Fraud & Security Intelligence
Jen Dunham 0
Opioid schemes fueled by staged car accidents, insurance fraud

Criminal enterprises are tapping into the lucrative opioid business through creative schemes that are less likely to be identified as opioid abuse, misuse or diversion. One of the latest schemes? Auto insurance fraud. First, some background… While extensive progress has been made in establishing, improving, and mandating prescription drug monitoring

Analytics | Fraud & Security Intelligence
John Stultz 0
What can agencies learn from massive Medicaid fraud busts?

On June 22nd, the U.S. Department of Justice announced the largest Medicaid fraud bust in history. The National Health Care Fraud Takedown included 301 defendants charged, $900 million in false billings, 61 medical professionals and 29 doctors, across 36 states. In another case, investigators in New York uncovered more than