Future of healthcare fraud is data-driven, US Feds Say

At the recent American Health Law Association Fraud and Compliance Forum, HHS Inspector General Christi Grimm and Assistant Attorney General Kenneth A. Polite, Jr. discussed trends and priorities in healthcare fraud enforcement.

The discussion focused on the critical role technology now plays in healthcare fraud investigation, compliance, and enforcement – as well as how the data generated by the healthcare industry guides agency decisions at all stages of the enforcement process. By analyzing data, the government can identify fraud incidents within organizations and identify trends and outliers that may indicate fraud. 

These data-driven investigations are conducted primarily by forensic accountants and information technology specialists rather than attorneys. Using these “technological Sherlocks,” investigators can quickly identify relevant trends, enabling investigations to proceed more efficiently and quickly.

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