This FBI article highlights recent action by the U.S. government to curb the opioid epidemic by charging more than 400 individuals for their alleged involvement in fraudulent schemes, including false Medicare billings. Many charges resulted from looking at trends and anomalies in submission and payment data at federal health insurance programs. The effect was widespread, with 41 federal districts affected. As noted in this Arkansas Business article, the dragnet even captured individuals not in the medical field.
As information becomes increasingly electronic, data analytics is an important and useful tool to combat fraud and abuse. Health institutions and pharmacies should consider using similar data analytics to be in front of the next dragnet and mitigate any potential liability. Learn more about BKD’s Big Data & Analytics services or contact your trusted advisor to discuss how data analytics might be able to help your company.