Medicare fraud strike force uses analytics to spot fraudulent billing
The Medicare Fraud Strike Force, a joint operation between the U.S. Justice Department and the Department of Health...
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and Human Services, announced the arrests of 90 people for Medicare fraud. The alleged false billing totaled roughly $260 million. Officials credited data mining techniques with helping them make the arrests.
Included in the takedown were 16 doctors, charged with intentionally bilking the system through fraudulent claims.
Medicare is known to be relatively easy to defraud. It is required to pay medical professionals for any and all claims upon receipt. Only after a claim has been paid can officials examine it for fraud -- but with the high volume of claims Medicare receives, fraud often goes undetected.
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This is why federal authorities turned to analytics. By applying data mining techniques to claims data, officials were able to easily spot suspicious billing patterns and identify individuals who were likely committing fraud. Acting Assistant Attorney General David O'Neil said in a news conference that this type of analysis was central to the agency's recent arrests.
"Using cutting-edge, data-driven investigative techniques we are bringing fraudsters to justice and saving the American taxpayers billions of dollars," he said.
IBM announces three new self-service analytics offerings
This week IBM became the latest analytics software vendor to jump on the self-service bandwagon, announcing a trio of new cloud offerings at its Vision 2014 conference aimed at line-of-business users and other non-techy types.
The move marks a shift for IBM, which received relatively low marks in the latest Gartner Magic Quadrant for Business Intelligence and Analytics for visualization software, embedded analytics and ease of use.
The new products include Concert, a cloud-based process intelligence and collaborative analytics tool; Project Catalyst, a self-service data discovery tool; and OpenPages, risk and governance software for driving compliance.
In a news release announcing the software, Alistair Rennie, general manager of business analytics at IBM, said the new products would help businesses get more employees involved in data analysis, thereby making data-driven decision-making a bigger part of operations.
This week's dataviz comes courtesy of Kevin Hamm of The Denver Post, who created a visualization to display data on parking violations in the Mile High City. Exploring the graphic, users can see which types of cars get the most tickets, locations where cars are most often ticketed and the times of day when the most tickets are written.