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Thursday, April 5 • 2:45pm - 3:45pm
Track 4: INDUSTRY SESSION - From Program Integrity to Life or Death: The case for using data and analytics to prevent healthcare fraud

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When people think of healthcare fraud, they often think of dollars. But, program integrity officials in state agencies know it’s more than that; it’s about people. Every dollar lost due to fraud, waste and abuse is a dollar that won’t be spent helping someone who needs the help. And, if that isn’t reason enough, we’re seeing the impact of fraud through the opioid crisis – provider pill mills, pharmacy scams and patient fraud. The only way to truly combat healthcare fraud, whether it is “traditional” claims-based fraud or challenges such as the opioid epidemic, is to have a complete picture of it and connect the dots between all the parties. The presenter will discuss how layering multiple data sets – patient data, provider data, associates data, agency data – and combining it with contributory data across government and other industries can help state agencies to detect and shut down fraud rings and scams.

avatar for Justin Hyde

Justin Hyde

Director of Planning, Health and Human Services, LexisNexis
Mr. Hyde has been instrumental in the LexisNexis Government Sector specifically in the strategy, design, and implementation of identity solutions for Health and Human Services agencies nationwide.His experience spans many fronts in the Government industry; both Federal and State... Read More →

Thursday April 5, 2018 2:45pm - 3:45pm PDT
Key Ballroom 10