New and advancing technology in social network analytics is helping to identify major Medicare fraud by examining data on major social networking sites including Facebook, Twitter and LinkedIn. The technology uses computing and association software which can see relationships, connections and links to information showing fraud in billing Medicare claims. Some of it is done with statistical analytic programs accessing vast public databases.
Federal agencies can search social networks to show all paid Medicare claims and then compare the relative charges against other similar healthcare providers to see who charges the most. Health and Human Services is using such data bases and says that it has a return of $7 dollars for each dollar invested in pursuing Medicare fraud through the use of such programs.
Social networks have been revealing how organized crime has entered health care fraud resulting in tens of billions of dollars of fraud which the taxpayers must pay. These groups steal the identities of doctors and billed for services to patients. Phony companies set up fake clinics which start billing. The Office of Inspector General estimates hat the losses for inappropriate government billing of health care services exceeds $60 billion.
Jeffrey Newman represents whistleblowers.