A hot button issue this election season was the need to determine the eligibility of people for various government programs like the Affordable Care Act (ACA), Medicare and Medicaid, or entry into the United States as a migrant refugee. “Look, we’re facing the worst refugee crisis since the end of
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
Currently, most fraud detection solutions for financial crime and tax fraud are focused on risk assessing entities. That is to say, they evaluate the risk of each individual or businesses separately. While this helps prioritize risk-based investigations by alerting investigators to the likelihood of fraud, it does not necessarily maximize deterrence.
