2018 State HIT Connect Summit

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.