The Commonwealth of Massachusetts Selects Detica NetReveal to Fight Medicaid Fraud and Abuse
<0> Articulate Communications Inc.Audra Tiner, +1 212 255.0080, ext. 34orBAE Systems DeticaNatasha Davies, Head of PR and MediaTelephone +44 (0) 20 7812 4274Mobile: +44 (0) 7787 297 831 </0>
, a business division of BAE Systems Detica, has been selected by the Commonwealth of Massachusetts’ Executive Office of Health and Human Services to help combat Medicaid fraud and abuse and to provide prepayment screening of the Commonwealth’s Medicaid claims. Detica NetReveal will help MassHealth manage cases of fraud, ensure compliance and provide solutions to potential abuses. The implementation of this program will put Massachusetts in the vanguard of federal and state efforts to combat fraud and abuse, a problem estimated to cost U.S. taxpayers in excess of $100 billion per year nationally.
The NetReveal solution will integrate with Massachusetts’ Medicaid Management Information System (MMIS) and will include public and other Commonwealth data to automatically assess risk scores associated with claims. This will enable analysts to review, investigate and approve or deny claims; avoiding the need for costly `pay and chase` investigations. High risk cases can be referred for detailed social network analysis to help identify related patterns of serious organized fraud and abuse. Implementation of the NetReveal solution will be led by Dynamics Research Corporation.
Fraud and abuse related to Medicaid and Medicare is a substantial problem and identifying fraud and abuse after it has happened is difficult and expensive. Detica NetReveal provides the latest predictive analytic techniques and innovative social network analysis to accurately identify claims that would likely lead to improper payments.
“Medicaid fraud and abuse is top of every Medicaid Program Integrity professional’s agenda. Detica NetReveal deploys advanced predictive analytics to identify suspicious patterns of behaviour, detect fraud and drastically reduce improper payments. Our technology will ensure that Massachusetts is ahead of those abusing the system, by stopping improper payments before they are made.”
Detica NetReveal is a leading provider of risk, fraud and compliance solutions to a wide range of financial services and government clients across the globe. The NetReveal suite of solutions combines predictive analytics with advanced social network analysis to identify suspicious behaviours more accurately than other solutions.
The power of our approach lies in the combination of specialist industry expertise with proven technology. We provide our clients with intelligence to more accurately assess the risk of the individual by better understanding the risk associated with the networks in which they operate. With over 130 clients across four continents, including six of the world’s current top 10 financial institutions, Detica NetReveal has a proven track record of tackling fraud, improving operational intelligence and reducing financial losses and reputational risk. Detica NetReveal, incorporating Norkom Technologies, is a business division of BAE Systems Detica.
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BAE Systems Detica delivers information intelligence solutions to government and commercial customers. We help them collect, exploit and manage data so they can deliver critical business services more effectively and economically. We also develop solutions to strengthen national security and resilience.
We integrate and deliver world-class solutions to our customers’ most complex operational problems – often applying our own unique intellectual property. Our services include cyber security, managing risk and compliance, data analytics, systems integration and managed services, strategy and business change and the development of innovative software and hardware technologies.
Detica is part of BAE Systems, a global defence and security company with approximately 100,000 employees worldwide. BAE Systems delivers a full range of products and services for air, land and naval forces, as well as advanced electronics, security, information technology solutions and customer support services.
BAE SYSTEMS, DETICA, NETREVEAL, Detica NetReveal are trade marks of BAE Systems plc.
Dynamics Research Corporation (DRC) provides measurable performance improvements for government customers through the delivery of innovative management consulting, engineering, science and technology solutions. DRC offers the capabilities of a large company and the responsiveness of a small company, backed by a history of excellence and customer satisfaction. Founded in 1955, DRC is a publicly held corporation () and maintains more than 25 offices nationwide with major offices in Andover, Massachusetts and the Washington, D.C. region. For more information please visit our website at .