A new task force announced by the West Virginia U.S. Attorney's Office will rely on data analytics to uncover healthcare fraud schemes.
The state enforcement initiative will be led by Assistant U.S. Attorney Sarah Montoro, who will oversee representatives from the U.S. Department of Health and Human Services, the Drug Enforcement Administration, the Federal Bureau of Investigation, the Internal Revenue Service, as well as Medicaid Fraud Control Units from West Virginia and Ohio.
According to U.S. Attorney William J. Ihlenfeld, the task force plans to rely heavily on "advanced statistical analysis" to identify billing anomalies that will generate new leads for investigators.
"The fraud detection tools that we're using allow us to identify sophisticated schemes that may have escaped scrutiny in the past," Ihlenfeld said in an announcement of the new program.
Last week, FierceHealthPayer: AntiFraud published a special report outlining the ways in which fraud fighters are using data analytics to detect sophisticated fraud schemes. Although Medicare Strike Force Teams already target nine high-risk areas of the country, states like Pennsylvania are building their own home-grown task force teams. Following June's historic fraud takedown, the Department of Justice has pointed to state partnerships as a key role in identifying and investigating fraud.
To learn more:
- read the US Attorney's Office announcement