Recently the largest ever fraud schemes by perpetrating a nationwide Medicare scam that billed Medicare for more than $100 million of unnecessary medical treatments using a series of phantom clinics was exposed. While it's upsetting to see millions of tax payors' money went into criminals' wallet, lessons need to be learned so the same crime wouldn't be able to taken place anymore.
In the process of investigation, information technology and data mining capabilities took great role in moving it forward. The Health Care Fraud Prevention and Enforcement Action Team (HEAT) use modern technology to complete in a matter of days analysis of electronic evidence that previously took months to analyze using traditional investigative tools; it also significantly improves data and information sharing between CMS and law enforcement to identify patterns that lead to fraud.
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