Advanced Analytics Is Changing How Agencies Fight Fraud

Through analytics, the Department of Justice was able to track down 16 people in Michigan and Ohio, including 12 physicians, who were sentenced last year for submitting more than $250 million in false claims and illegally distributing more than 6.6 million opioid pills.
Data analyzed by the DOJ’s Health Care Fraud Unit uncovered a list of doctors who gave patients an unusually high number of expensive back pain injections. It was determined that the doctors refused to give the patients opioid prescriptions unless they agreed to receive the medically unnecessary injections. The physicians then…