Copyright 2012, SAS Institute Inc. All rights reserved. USING ANALTYICS IN GOVERNMENT

Size: px
Start display at page:

Download "Copyright 2012, SAS Institute Inc. All rights reserved. USING ANALTYICS IN GOVERNMENT"

Transcription

1 Copyright 2012, SAS Institute Inc. All rights reserved. USING ANALTYICS IN GOVERNMENT

2 AN INTRODUCTION TO ANALYTICS THE CONTINUUM OF ANALYTICS CAPABILITIES BI Advanced Analytics Analytics Copyright 2012, SAS Institute Inc. All rights reserved.

3 AND ANALYTIC COMPETENCE

4 AND ANALYTIC COMPETENCE How many patients did we serve across the state?

5 AND ANALYTIC COMPETENCE

6 AND ANALYTIC COMPETENCE

7 AND ANALYTIC COMPETENCE How many patients were served by more than 4 programs across multiple Agencies and at what cost per family?

8 AND ANALYTIC COMPETENCE

9 AND ANALYTIC COMPETENCE

10 AND ANALYTIC COMPETENCE How can we best optimize the use of Mental Health program expenditures across our most vulnerable citizens?

11 AND ANALYTIC COMPETENCE

12 AND ANALYTIC COMPETENCE

13 AND ANALYTIC COMPETENCE How do we best manage risk and maximize return on our State Pension fund investments?

14 AND ANALYTIC COMPETENCE

15 AND ANALYTIC COMPETENCE

16 ANALYTICS 3.0 THE USE OF DATA AND ANALYTICS IS RAPIDLY EVOLVING 1.0 Traditional Analytics 3.0 Fast Business Impact for the Data Economy 2.0 Big Data Source: International Institute for Analytics/Tom Davenport, 2013

17 ANALYTICS UNDERSTANDING OF HOW TO ACHIEVE GOALS & OBJECTIVES Who is benefiting from our services? How well are our programs working? What services do we need to provide in the future? How much will we spend? How do we keep kids safe? What is the best combination of services? How can we reduce the tax gap? How can we reduce improper payments? How can we facilitate a healthier population? What are our customers saying right now? A holistic view of citizens, services and providers! Copyright 2012, SAS Institute Inc. All rights reserved.

18 ADVANCED ANALYTICS INSIGHT TO HELP YOU TAKE ACTION What is the RISK of a specific person/case/return What is the BEST thing to do in a given situation to have the desired outcome

19 ADVANCED ANALYTICS RISK Advanced analytics that identify: Tax returns or claims that are fraudulent People who are at risk for abuse and/or neglect How dangerous a person or situation is The risk of a health outbreak

20 ADVANCED ANALYTICS BEST ACTION Advanced analytics to tell you the best actions to take, requiring the least effort/intervention in order to: Change behavior (health, compliance) Collect amounts owed Reduce operational costs Increase revenues/customers Help children/adults advance academically

21 ADVANCED ANALYTICS IMPACT Continuously identify the most important things to work on Have all the information needed for decisions at your fingertips Reduce risk by understanding a situation completely Eliminate manual processes Reduce improper payments Increase revenue Achieve outcomes

22 OPPORTUNITIES TO USE ANALYTICS IN GOVERNMENT Justice & Public Safety Criminal Justice Integration Criminal Justice Outcomes Law Enforcement Transportation Public Finance Tax/Revenue Audit Tax/Revenue Collections Performance Management Budget Fraud, Waste & Abuse Medicaid TANF (Child Care, Cash Assistance) SNAP Workers Comp/Unemployment Govt. Services & Education Student/Teacher Assessment Natural Resources/Environment System Modernization Resource Health & Social Services Master Patient/Citizen Index Eligibility Health Outcomes Program Effectiveness Child Support Enforcement Copyright 2012, SAS Institute Inc. All rights reserved.

23 THANK YOU! Sarah Gates State Client Executive, Oregon and Washington Cell: Copyright 2012, SAS Institute Inc. All rights reserved.

Using Data Analytics to Identify Fraud, Waste, and Abuse

Using Data Analytics to Identify Fraud, Waste, and Abuse Using Data Analytics to Identify Fraud, Waste, and Abuse Pacific Northwest and Western Intergovernmental Audit Forum September 3, 2015 Joah G Iannotta, Ph.D. Assistant Director, Forensic Audits and Investigative

More information

Stop Elder Financial Abuse: Protecting the economic well-being of our senior citizens

Stop Elder Financial Abuse: Protecting the economic well-being of our senior citizens Stop Elder Financial Abuse: Protecting the economic well-being of our senior citizens What is elder financial abuse? Elder financial abuse is a specific form of the crime of financial abuse. Financial

More information

THE MEDICARE-MEDICAID (MEDI-MEDI) DATA MATCH PROGRAM

THE MEDICARE-MEDICAID (MEDI-MEDI) DATA MATCH PROGRAM Department of Health and Human Services OFFICE OF INSPECTOR GENERAL THE MEDICARE-MEDICAID (MEDI-MEDI) DATA MATCH PROGRAM Daniel R. Levinson Inspector General April 2012 OEI-09-08-00370 EXECUTIVE SUMMARY:

More information

North Carolina Government Data Analytics Center Program. May 2014. North Carolina Office of the State Controller

North Carolina Government Data Analytics Center Program. May 2014. North Carolina Office of the State Controller North Carolina Government Data Analytics Center Program May 2014 North Carolina Office of the State Controller James G. Dolan, Acting State Controller Contents Executive Summary... 4 I. GDAC Background...

More information

Guide to Health and Social Services

Guide to Health and Social Services Guide to Health and Social Services Health Services If you have little or no insurance and need health services: You can visit one of the 159 county health departments across the state. The local health

More information

U.S. Department of Justice. Becoming A. Special Agent. U.S. Department of Justice Office of the Inspector General INVESTIGATIONS DIVISION

U.S. Department of Justice. Becoming A. Special Agent. U.S. Department of Justice Office of the Inspector General INVESTIGATIONS DIVISION U.S. Department of Justice Office of the Inspector General Becoming A Special Agent INVESTIGATIONS DIVISION OFFICE OF THE INSPECTOR GENERAL U.S. Department of Justice The OIG plays an integral role in

More information

Business Intelligence

Business Intelligence Business Intelligence Revenue Agency Opportunities Copyright 2005 Accenture. All rights reserved. Proprietary and Conf idential Material. Accenture and its logo, and Accenture Innovation Delivered are

More information

2013 Long Session Final Report N.C. General Assembly Social Services Consortium Biennium Legislative Priorities

2013 Long Session Final Report N.C. General Assembly Social Services Consortium Biennium Legislative Priorities 2013 Long Session Final Report N.C. General Assembly Social Services Consortium Biennium Legislative Priorities 1 Fully Fund Mandated Services First from Federal Block Grants (TANF and SSBG) To not cut

More information

Chapter 5. Planning the Audit Engagement

Chapter 5. Planning the Audit Engagement Chapter 5 Planning the Audit Engagement A. Purpose for Planning the Engagement Engagement planning is performed to provide a means for developing an understanding of the business objectives of the auditee,

More information

September 9, 2013 Don Hoag Deloitte Consulting, LLP dhoag@deloitte.com

September 9, 2013 Don Hoag Deloitte Consulting, LLP dhoag@deloitte.com You Know You Have A Data Governance Problem When How One State Made The Upgrade September 9, 2013 Don Hoag Deloitte Consulting, LLP dhoag@deloitte.com Today s Session 1. Background 2. Vision for Implementing

More information

Need Scenic Photo Here

Need Scenic Photo Here Need Scenic Photo Here DEPARTMENT OF HUMAN SERVICES Citizens Plaza Building 400 Deaderick Street Nashville, TN 37248-0001 (615) 313-4700 Tennessee.gov/humanserv Virginia T. Lodge, Commissioner Ed Lake,

More information

Data Warehouse. Richard Burgis Manager, Database Area Supporting DHS/CSES Department of Information Technology, State of Michigan

Data Warehouse. Richard Burgis Manager, Database Area Supporting DHS/CSES Department of Information Technology, State of Michigan Click Michigan s to add Statewide text Data Warehouse Richard Burgis Manager, Database Area Supporting DHS/CSES Department of Information Technology, State of Michigan 6/23/2008 MDW: A Critical Statewide

More information

Oregon Department of Human Services. Seniors and People with Disabilities Children, Adults and Families

Oregon Department of Human Services. Seniors and People with Disabilities Children, Adults and Families Oregon Department of Human Seniors and People with Disabilities Children, Adults and Families Oregon Department of Human The Challenge Ahead Over the past several years the Oregon Department of Human has

More information

Program Integrity CURRENT FRAUD AND ABUSE INITIATIVES IN NORTH CAROLINA

Program Integrity CURRENT FRAUD AND ABUSE INITIATIVES IN NORTH CAROLINA Program Integrity CURRENT FRAUD AND ABUSE INITIATIVES IN NORTH CAROLINA OVERVIEW Program Integrity (PI) Attorney General Medicaid Fraud Investigation Unit (AGO/MIU) Advanced Med (Medi-Medi) Zone Program

More information

Achieving Real Program Integrity 2011 NAMD Annual Conference

Achieving Real Program Integrity 2011 NAMD Annual Conference Achieving Real Program Integrity 2011 NAMD Annual Conference Center for Program Integrity Centers for Medicare & Medicaid Services Angela Brice-Smith Director, Medicaid Integrity Group November 9, 2011

More information

Predictive Analytics for Government Chih-Feng Ku Solutions Manager, Business Analytics IBM Asia Pacific Business Analytics

Predictive Analytics for Government Chih-Feng Ku Solutions Manager, Business Analytics IBM Asia Pacific Business Analytics Predictive Analytics for Government Chih-Feng Ku Solutions Manager, Business Analytics IBM Asia Pacific Business Analytics 1 The world is changing and becoming more Instrumented Interconnected Intelligent

More information

PREDICTIVE ANALYTICS IN FRAUD

PREDICTIVE ANALYTICS IN FRAUD PREDICTIVE ANALYTICS IN FRAUD Click Scott to White edit Master subtitle style Business Development Manager Why predict? Organizations that use predictive business performance metrics will increase their

More information

Center for Program Integrity

Center for Program Integrity Center for Program Integrity Peter Budetti, Deputy Administrator Director, Center for Program Integrity National Conference of State Legislators Spring Forum April 14, 2011 Center for Program Integrity

More information

Table of Contents 2016-17 Biennial Budget Attorney General

Table of Contents 2016-17 Biennial Budget Attorney General Table of Contents 2016-17 Biennial Budget Attorney General Agency Profile Attorney General... 1 Administrative Law Section... 2 State Services Section... 3 Public Services Section... 4 Regulatory Law Section...

More information

Table of Contents 2014-15 Governors Budget - Attorney General. Agency Profile. - Attorney General... 1

Table of Contents 2014-15 Governors Budget - Attorney General. Agency Profile. - Attorney General... 1 Table of Contents 2014-15 Governors Budget - Attorney General Agency Profile. - Attorney General... 1 Current, Base and Governor's Recommended Expenditures... 3 Sources and Uses... 4 All Funds FTE by Activity...

More information

Data Integration in North Carolina

Data Integration in North Carolina Data Integration in North Carolina OSC Financial Conference December 12, 2012 North Carolina Office of the State Controller Kay Meyer, Program Director Data Integration Section Purpose: Merge and reconcile

More information

OREGON PROPERLY VERIFIED CORRECTION OF DEFICIENCIES IDENTIFIED DURING SURVEYS OF NURSING HOMES PARTICIPATING IN MEDICARE AND MEDICAID

OREGON PROPERLY VERIFIED CORRECTION OF DEFICIENCIES IDENTIFIED DURING SURVEYS OF NURSING HOMES PARTICIPATING IN MEDICARE AND MEDICAID Department of Health and Human Services OFFICE OF INSPECTOR GENERAL OREGON PROPERLY VERIFIED CORRECTION OF DEFICIENCIES IDENTIFIED DURING SURVEYS OF NURSING HOMES PARTICIPATING IN MEDICARE AND MEDICAID

More information

WELFARE FRAUD PREVENTION ACT. Section 1. Definitions. For purposes of this Act, the following definitions apply:

WELFARE FRAUD PREVENTION ACT. Section 1. Definitions. For purposes of this Act, the following definitions apply: WELFARE FRAUD PREVENTION ACT Section 1. Definitions. For purposes of this Act, the following definitions apply: A. Department means {insert state public welfare departments, agencies or offices where eligibility

More information

Affordable Care Act Reviews

Affordable Care Act Reviews Appendix A: Affordable Care Act Reviews Appendix A: Affordable Care Act Reviews New Programs and Initiatives Created by the Affordable Care Act... 1 Pre-Existing Condition Insurance Plans, 1101...2 Controls

More information

Effects of Child Poverty

Effects of Child Poverty Effects of Child Poverty HIGHLIGHTS On a variety of health indicators, both children and parents in poverty fare worse than those at higher income levels. Young children are especially vulnerable to the

More information

Supreme Court upholds the Affordable Care Act in its entirety:

Supreme Court upholds the Affordable Care Act in its entirety: Supreme Court upholds the Affordable Care Act in its entirety: What does this mean for Seniors? The Supreme Court s decision to uphold the Affordable Care Act (ACA) in its entirety is a huge victory for

More information

Summit 2015 Orlando London Frankfurt Madrid Mexico City

Summit 2015 Orlando London Frankfurt Madrid Mexico City The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes David Small Sr. Vice President International Summit 2015 Orlando London Frankfurt Madrid Mexico City Consumer

More information

Treasury Inspector General Tax Administration (TIGTA)

Treasury Inspector General Tax Administration (TIGTA) Treasury Inspector General Tax Administration (TIGTA) 1 Finding The RED DOT in Tax Administration s BIG DATA OR Reducing the Hay to Find a Needle 2 Background on IRS and TIGTA s Oversight Role Selected

More information

Turning Data into Reality:

Turning Data into Reality: WHITE PAPER Turning Data into Reality: Seizing the Opportunity for Transformation Using Big Data Analytics in Human Services May 2013 1 cgi.com 2013 CGI GROUP INC. Introduction The chatter around big data

More information

Managing debt owed to central government

Managing debt owed to central government Report by the Comptroller and Auditor General Cross-government Managing debt owed to central government HC 967 SESSION 2013-14 14 FEBRUARY 2014 4 Key facts Managing debt owed to central government Key

More information

North Carolina Government Data Analytics Center

North Carolina Government Data Analytics Center North Carolina Government Data Analytics Center Report to the Chairs of the House of Representatives Appropriations Committee Chairs of the Senate Based Budget/Appropriations Committee Joint Legislative

More information

GAO BANKRUPTCY AND CHILD SUPPORT ENFORCEMENT. Improved Information Sharing Possible without Routine Data Matching. Report to Congressional Committees

GAO BANKRUPTCY AND CHILD SUPPORT ENFORCEMENT. Improved Information Sharing Possible without Routine Data Matching. Report to Congressional Committees GAO United States Government Accountability Office Report to Congressional Committees January 2008 BANKRUPTCY AND CHILD SUPPORT ENFORCEMENT Improved Information Sharing Possible without Routine Data Matching

More information

,2 2 2009 MAY. oß.vi.. Daniel R. Levinson ~ ~ .~~.vi...

,2 2 2009 MAY. oß.vi.. Daniel R. Levinson ~ ~ .~~.vi... (?.,,,-l'''4,,"vicø -r..'..ll'..410 DEPARTMENT OF HEALTH &. HUMAN SERVICES Office of Inspector General Washington, D.C. 20201 MAY,2 2 2009 TO: James Scanlon Acting Assistant Secretary for Planning Planing

More information

The United States spends more than $1 trillion each year on healthcare

The United States spends more than $1 trillion each year on healthcare Managed Care Fraud and Abuse Compliance Guidelines I. Introduction The United States spends more than $1 trillion each year on healthcare representing approximately 15 percent of the gross national product.

More information

Human Services Page 1 of 6

Human Services Page 1 of 6 HUMAN SERVICES Human Services Page 1 of 6 BACKGROUND The mission of Mesa County Department of Human Services is to help individuals and families achieve safety, independence and self-sufficiency through

More information

Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics. David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014

Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics. David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014 Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014 Agenda The Triple Aim Population Health in Russia The

More information

How To Transform Health And Human Services With Data Analytics

How To Transform Health And Human Services With Data Analytics Experience the commitment WHITE PAPER Turning data into reality Seizing the opportunity for transformation using big data analytics in human services September 2013 cgi.com /stateandlocal 2013 CGI GROUP

More information

AN ACT RELATING TO SUBSTANCE ABUSE; PROVIDING FOR TREATMENT, BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

AN ACT RELATING TO SUBSTANCE ABUSE; PROVIDING FOR TREATMENT, BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: AN ACT RELATING TO SUBSTANCE ABUSE; PROVIDING FOR TREATMENT, PREVENTION AND INTERVENTION EXPANSION; MAKING APPROPRIATIONS; DECLARING AN EMERGENCY. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

More information

Predict. Prevent. Protect. Transform.

Predict. Prevent. Protect. Transform. Optum solution uses global positioning system technology for Optum (CES) is an open-architecture claims editing tool that Program Integrity Solutions Optum provides 30 years worth of government expertise

More information

North Carolina Government Business Intelligence Competency Center Program. June 2013. North Carolina Office of the State Controller

North Carolina Government Business Intelligence Competency Center Program. June 2013. North Carolina Office of the State Controller North Carolina Government Business Intelligence Competency Center Program June 2013 North Carolina Office of the State Controller David T. McCoy, State Controller Table of Contents Executive Summary...2

More information

Preventing Health Care Fraud

Preventing Health Care Fraud Preventing Health Care Fraud Project: Predictive Modeling for Fraud Detection at MassHealth Category: Improving State Operations Commonwealth of Massachusetts Executive Office of Health and Human Services

More information

Preventing Healthcare Fraud through Predictive Modeling. Category: Improving State Operations

Preventing Healthcare Fraud through Predictive Modeling. Category: Improving State Operations Preventing Healthcare Fraud through Predictive Modeling Category: Improving State Operations Commonwealth of Massachusetts Executive Office of Health and Human Services Project initiated: July 2012 Project

More information

Risk Management. Did you know? What is Risk Management?

Risk Management. Did you know? What is Risk Management? Risk Did you know? Financial services organizations help people buy houses, build businesses and protect their families financially. Banks, insurance companies, asset managers, pension administrators and

More information

Georgia Department of Human Services Georgia Senior Supplemental Nutrition Assistance Program (SNAP) Application

Georgia Department of Human Services Georgia Senior Supplemental Nutrition Assistance Program (SNAP) Application Georgia Department of Human Services Georgia Senior Supplemental Nutrition Assistance Program (SNAP) Application This application is used for individuals applying for the Supplemental Nutrition Assistance

More information

Official Audit Report Issued July 27, 2015

Official Audit Report Issued July 27, 2015 Official Audit Report Issued July 27, 2015 (MassHealth) Review of Radiology Claims Submitted by Baystate Mary Lane Hospital For the period January 1, 2013 through December 31, 2014 State House Room 230

More information

The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes

The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes Michael Corcoran Sr. Vice President & CMO Dr. Rado Kotorov Vice President, Market Strategy Summit 2015 Orlando

More information

From Business Intelligence to Predictive Analytics. James Taylor CEO, Decision Management Solutions

From Business Intelligence to Predictive Analytics. James Taylor CEO, Decision Management Solutions From Business Intelligence to Predictive Analytics James Taylor CEO, Decision Management Solutions Your presenter James Taylor CEO of Decision Management Solutions Works with clients to improve their business

More information

Beyond passwords: Protect the mobile enterprise with smarter security solutions

Beyond passwords: Protect the mobile enterprise with smarter security solutions IBM Software Thought Leadership White Paper September 2013 Beyond passwords: Protect the mobile enterprise with smarter security solutions Prevent fraud and improve the user experience with an adaptive

More information

Tim Blevins Execu;ve Director Labor and Revenue Solu;ons. FTA Technology Conference August 4th, 2015

Tim Blevins Execu;ve Director Labor and Revenue Solu;ons. FTA Technology Conference August 4th, 2015 Tim Blevins Execu;ve Director Labor and Revenue Solu;ons FTA Technology Conference August 4th, 2015 Governance and Organiza;onal Strategy PaIerns of Fraud and Abuse in Government What tools can we use

More information

Office Hours and Availability

Office Hours and Availability Clinton B. Clark, MA, LPC Counselor/Group Leader PO Box 365; Conifer, CO 80433 Phone: 303-591-7675 / email: clint@clintclarkma.com www.clintclarkma.com Important Information and Policies as You Begin Counseling

More information

Copyright 2013 wolfssl Inc. All rights reserved. 2

Copyright 2013 wolfssl Inc. All rights reserved. 2 - - Copyright 2013 wolfssl Inc. All rights reserved. 2 Copyright 2013 wolfssl Inc. All rights reserved. 2 Copyright 2013 wolfssl Inc. All rights reserved. 3 Copyright 2013 wolfssl Inc. All rights reserved.

More information

The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes. Summit 2015 Orlando London Frankfurt Madrid Mexico City

The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes. Summit 2015 Orlando London Frankfurt Madrid Mexico City The New Landscape of Business Intelligence & Analytics New Opportunities, Roles and Outcomes Michael Corcoran Sr. Vice President & CMO Dr. Rado Kotorov Vice President, Market Strategy Summit 2015 Orlando

More information

Haley A. Schwartz, Esq. Director, Cancer Legal Initiative & Breast Cancer Legal Project Atlanta Legal Aid Society, Inc. Goals of our discussion: Brief background about the Atlanta Legal Aid Society Inspire

More information

Information Management in Government Leveraging Big Data

Information Management in Government Leveraging Big Data Information Management in Government Leveraging Big Data Kevin Redmond Central & Eastern Europe Information Management Executive 1 March 18, 2014 Governments must lead in the face of global challenges

More information

HIPAA and Privacy Policy Training

HIPAA and Privacy Policy Training HIPAA and Privacy Policy Training July 2015 1 This training addresses the requirements for maintaining the privacy of confidential information received from HFS and DHS (the Agencies). During this training

More information

VALPARAISO UNIVERSITY NOTICE OF PRIVACY PRACTICES. Health, Dental and Vision Benefits Health Care Reimbursement Account

VALPARAISO UNIVERSITY NOTICE OF PRIVACY PRACTICES. Health, Dental and Vision Benefits Health Care Reimbursement Account VALPARAISO UNIVERSITY NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

More information

Not Conducting Internal Billing Audits? Think Again

Not Conducting Internal Billing Audits? Think Again Not Conducting Internal Billing Audits? Think Again By Nancy Nager and Kenneth A. Davis For the past decade there has been increased government scrutiny of Medicare and Medicaid payments to providers of

More information

Auditor or Program Analyst

Auditor or Program Analyst U.S. Department of Justice Office of the Inspector General Becoming an Auditor or Program Analyst AUDIT DIVISION OFFICE OF THE INSPECTOR GENERAL U.S. Department of Justice The OIG plays an integral role

More information

As Amended by Senate Committee SENATE BILL No. 408

As Amended by Senate Committee SENATE BILL No. 408 Session of As Amended by Senate Committee SENATE BILL No. 0 By Committee on Corrections and Juvenile Justice - 0 AN ACT concerning abuse, neglect and exploitation of persons; relating to reporting and

More information

THE 2014 THREAT DETECTION CHECKLIST. Six ways to tell a criminal from a customer.

THE 2014 THREAT DETECTION CHECKLIST. Six ways to tell a criminal from a customer. THE 2014 THREAT DETECTION CHECKLIST Six ways to tell a criminal from a customer. Telling criminals from customers online isn t getting any easier. Attackers target the entire online user lifecycle from

More information

ESTATE PLANNING WORKSHEET

ESTATE PLANNING WORKSHEET ESTATE PLANNING WORKSHEET Prospective Client- In order to best serve you and your interests, complete and return this packet as soon as possible. This will allow us to understand the specifics of your

More information

How Proposed Cuts in Vital Services Will Hurt New Jersey

How Proposed Cuts in Vital Services Will Hurt New Jersey How Proposed Cuts in Vital Services Will Hurt New Jersey January 12, 2006 On February 1, 2006, the U.S. House of Representatives is scheduled to take up legislation cutting $40 billion in health care,

More information

Healthcare Solutions: Giving you the freedom to care.

Healthcare Solutions: Giving you the freedom to care. Healthcare Solutions: Giving you the freedom to care. viders Our deep industry-wide experience helps create better outcomes across the entire healthcare ecosystem. Gove Better Outcomes What s the business

More information

Physicians Often Fail to Report Suspected Elder Abuse

Physicians Often Fail to Report Suspected Elder Abuse Richard A. Courtney, CELA Certified Elder Law Attorney 4400 Old Canton Road, Suite 220 Jackson, Mississippi 39211 601-987-3000 or 1-866-ELDERLAW For more Articles, go to: www.elderlawms.com Physicians

More information

Helping Physicians Drive Better Practice Health

Helping Physicians Drive Better Practice Health McKesson Business Performance Services Revenue Cycle Management Services Helping Physicians Drive Better Practice Health McKesson Business Performance Services Our staff of 7,000+ includes 500+ certified

More information

www.publicpartnerships.com Providing solutions that balance participant direction with fiscal accountability.

www.publicpartnerships.com Providing solutions that balance participant direction with fiscal accountability. www.publicpartnerships.com Providing solutions that balance participant direction with fiscal accountability. Empowering individuals with disabilities and their families to manage their own care, supports,

More information

Medicaid Fraud Prevention & Detection

Medicaid Fraud Prevention & Detection Medicaid Fraud Prevention & Detection Best practices for combating fraud, waste, and abuse 2012 Dun & Bradstreet Executive Summary Medicaid fraud, waste and abuse cost taxpayers up to $160 billion annually

More information

Presentation to the 2015 Health and Human Services Joint Appropriation Subcommittee

Presentation to the 2015 Health and Human Services Joint Appropriation Subcommittee Presentation to the 2015 Health and Human Services Joint Appropriation Subcommittee QUALITY ASSURANCE DIVISION Operations Services Branch Department of Public Health and Human Services Reference: Legislative

More information

National Medicare fraud takedown results in charges against 243 individuals for approximately $712 million in false billing

National Medicare fraud takedown results in charges against 243 individuals for approximately $712 million in false billing National Medicare fraud takedown results in charges against 243 individuals for approximately $712 million in false billing Most defendants charged and largest alleged loss amount in Strike Force history

More information

Stopping the Flow of Health Care Fraud with Technology, Data and Analytics

Stopping the Flow of Health Care Fraud with Technology, Data and Analytics White Paper and New Ways to Fight It Stopping the Flow of Health Care Fraud with Technology, Data and Analytics January 2014 Health care costs are rising and everyone is being affected, including patients,

More information

A Multitier Fraud Analytics and Detection Approach

A Multitier Fraud Analytics and Detection Approach A Multitier Fraud Analytics and Detection Approach Jay Schindler, PhD MPH DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official

More information

What is fraud and abuse?

What is fraud and abuse? Medicaid Cost Containment: Combatting Fraud & Abuse What is fraud and abuse? $22 Billion: Medicaid improper payments FY2011 Fraud: misrepresentation of services rendered Abuse: practices that, either directly

More information

9. WILL THE INFORMATION I GIVE BE CHECKED? Yes and we may also ask you to send written proof.

9. WILL THE INFORMATION I GIVE BE CHECKED? Yes and we may also ask you to send written proof. Dear Parent/Guardian: Children need healthy meals to learn. Your child s school offers healthy meals every school day. Your childr en may qualify for free meals or for reduced price meals. 1. DO I NEED

More information

Medicaid Fraud and Abuse Investigations, Prosecutions and Compliance Strategies

Medicaid Fraud and Abuse Investigations, Prosecutions and Compliance Strategies Combating Medicaid Fraud & Abuse: Implications of the Medicaid Integrity Program October 24, 2006 Medicaid Fraud and Abuse Investigations, Prosecutions and Compliance Strategies John T. Bentivoglio jbentivoglio@kslaw.com

More information

California s Alternative Sentencing Law for Veterans and Members of the U.S. Military

California s Alternative Sentencing Law for Veterans and Members of the U.S. Military California s Alternative Sentencing Law for Veterans and Members of the U.S. Military You re a veteran, or maybe you re still in the military. But now you re looking at time in county jail or state prison.

More information

Schindler Elevator Corporation

Schindler Elevator Corporation -4539 Telephone: (973) 397-6500 Mail Address: P.O. Box 1935 Morristown, NJ 07962-1935 NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU

More information

Appendix L: Nebraska s False Medicaid Claims Act Nebraska Statues Chapter 68 November 2013 Section 68-935 Terms, defined.

Appendix L: Nebraska s False Medicaid Claims Act Nebraska Statues Chapter 68 November 2013 Section 68-935 Terms, defined. Appendix L: Nebraska s False Medicaid Claims Act Nebraska Statues Chapter 68 November 2013 Section 68-935 Terms, defined. For purposes of the False Medicaid Claims Act: A. Attorney General means the Attorney

More information

A summary of administrative remedies found in the Program Fraud Civil Remedies Act

A summary of administrative remedies found in the Program Fraud Civil Remedies Act BLACK HILLS SPECIAL SERVICES COOPERATIVE'S POLICY TO PROVIDE EDUCATION CONCERNING FALSE CLAIMS LIABILITY, ANTI-RETALIATION PROTECTIONS FOR REPORTING WRONGDOING AND DETECTING AND PREVENTING FRAUD, WASTE

More information

Administrative Policy and Procedure Manual. Code of Conduct Effective Date: 1/2005 Scope: Organizationwide Page 1 of 9

Administrative Policy and Procedure Manual. Code of Conduct Effective Date: 1/2005 Scope: Organizationwide Page 1 of 9 Scope: Organizationwide Page 1 of 9 I. Purpose The purpose of this policy is to provide direction to staff members to assist in carrying out daily activities within appropriate ethical and legal standards.

More information

Implementing a New Technology: FPS Successes, Challenges, and Best Practices

Implementing a New Technology: FPS Successes, Challenges, and Best Practices Implementing a New Technology: FPS Successes, Challenges, and Best Practices Centers for Medicare & Medicaid Services Raymond Wedgeworth Director, Data Analytics and Control Group Center for Program Integrity

More information

SDC-League Health Fund

SDC-League Health Fund SDC-League Health Fund 1501 Broadway, 17 th Floor New York, NY 10036 Tel: 212-869-8129 Fax: 212-302-6195 E-mail: health@sdcweb.org NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION

More information

OFFICE OF INSPECTOR GENERAL

OFFICE OF INSPECTOR GENERAL Department of Health and Human Services OFFICE OF INSPECTOR GENERAL REVIEW OF THE MASSACHUSETTS INSURANCE INTERCEPT PROGRAM JANET REHNQUIST Inspector General SEPTEMBER 2002 A-01-02-02501 Office of Inspector

More information

MODULE 11: NEW YORK STATE SENIOR MEDICARE PATROL (SMP) HEALTH CARE FRAUD, WASTE AND ABUSE

MODULE 11: NEW YORK STATE SENIOR MEDICARE PATROL (SMP) HEALTH CARE FRAUD, WASTE AND ABUSE MODULE 11: NEW YORK STATE SENIOR MEDICARE PATROL (SMP) HEALTH CARE FRAUD, WASTE AND ABUSE Project Goals Empowering Seniors to Prevent Healthcare Fraud. To raise awareness of and prevent Medicare and Medicaid

More information

UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA. NOTICE TO CONSUMER DEBTOR(S) UNDER 342(b) OF THE BANKRUPTCY CODE

UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA. NOTICE TO CONSUMER DEBTOR(S) UNDER 342(b) OF THE BANKRUPTCY CODE B 201 (12/08) UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA NOTICE TO CONSUMER DEBTOR(S) UNDER 342(b) OF THE BANKRUPTCY CODE In accordance with 342(b) of the Bankruptcy Code, this notice to individuals

More information

MAY 292008. Report Number: A-OI-07-00009

MAY 292008. Report Number: A-OI-07-00009 DEPARTMENT OF HEALTH & HUMAN SERVICES MAY 292008 OF'FICE OF INSPECTOR GENERAL Office I1f Audit Services Region I John F, Kennedy Federal Building Bestee, MA 02203 (617) 5(;5-2684 Report Number: A-OI-07-00009

More information

United States Attorney A. Brian Albritton Middle District of Florida. Tampa Orlando Jacksonville Fort Myers Ocala

United States Attorney A. Brian Albritton Middle District of Florida. Tampa Orlando Jacksonville Fort Myers Ocala United States Attorney A. Brian Albritton Middle District of Florida Tampa Orlando Jacksonville Fort Myers Ocala FOR IMMEDIATE RELEASE CONTACT: STEVE COLE TUESDAY, MAY 5, 2009 PHONE: (813) 274-6136 http://www.usdoj.gov/usao/flm/pr

More information

NewYork-Presbyterian Hospital Sites: All Centers Hospital Policy and Procedure Manual Number: D160 Page 1 of 9

NewYork-Presbyterian Hospital Sites: All Centers Hospital Policy and Procedure Manual Number: D160 Page 1 of 9 Page 1 of 9 TITLE: FEDERAL DEFICIT REDUCTION ACT OF 2005 FRAUD AND ABUSE PROVISIONS POLICY: NewYork- Presbyterian Hospital (NYP or the Hospital) is committed to preventing and detecting any fraud, waste,

More information

EYE ON FRAUD, WASTE, AND ABUSE

EYE ON FRAUD, WASTE, AND ABUSE EYE ON FRAUD, WASTE, AND ABUSE Introduction Fraud, waste, and abuse cost government agencies and taxpayers staggering amounts of money each year. All agencies remain susceptible to people who routinely

More information

Our Data Analytics Journey, Methodology, and More. September 15, 2015

Our Data Analytics Journey, Methodology, and More. September 15, 2015 Our Data Analytics Journey, Methodology, and More September 15, 2015 Objectives High-level Objectives: Discuss Audit Data Analytics History Industry Personal History TIAA-CREF History Define our data analytics

More information

Policies and Procedures SECTION:

Policies and Procedures SECTION: PAGE 1 OF 5 I. PURPOSE The purpose of this Policy is to fulfill the requirements of Section 6032 of the Deficit Reduction Act of 2005 by providing to Creighton University employees and employees of contractors

More information

LOCAL NEEDS LOCAL DECISI NS LOCAL BOARDS

LOCAL NEEDS LOCAL DECISI NS LOCAL BOARDS ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH BOARDS OF OHIO The Value of Ohio s Alcohol, Drug Addiction, and Mental Health Boards Providing hope and helping local communities thrive ++--------- LOCAL NEEDS

More information

MASSACHUSETTS MEDICAID PAYMENTS TO ESSEX PARK REHABILITATION AND NURSING CENTER DID NOT ALWAYS COMPLY WITH FEDERAL AND STATE REQUIREMENTS

MASSACHUSETTS MEDICAID PAYMENTS TO ESSEX PARK REHABILITATION AND NURSING CENTER DID NOT ALWAYS COMPLY WITH FEDERAL AND STATE REQUIREMENTS Department of Health and Human Services OFFICE OF INSPECTOR GENERAL MASSACHUSETTS MEDICAID PAYMENTS TO ESSEX PARK REHABILITATION AND NURSING CENTER DID NOT ALWAYS COMPLY WITH FEDERAL AND STATE REQUIREMENTS

More information

WHITE PAPER ON THE JUDICIAL SYSTEM FOR THE ELDER JUSTICE COORDINATING COUNCIL

WHITE PAPER ON THE JUDICIAL SYSTEM FOR THE ELDER JUSTICE COORDINATING COUNCIL WHITE PAPER ON THE JUDICIAL SYSTEM FOR THE ELDER JUSTICE COORDINATING COUNCIL Written by Lori A. Stiegel, Senior Attorney 1 American Bar Association Commission on Law and Aging OVERVIEW Growth of the older

More information

GAO FRAUD DETECTION SYSTEMS. Centers for Medicare and Medicaid Services Needs to Ensure More Widespread Use. Report to Congressional Requesters

GAO FRAUD DETECTION SYSTEMS. Centers for Medicare and Medicaid Services Needs to Ensure More Widespread Use. Report to Congressional Requesters GAO United States Government Accountability Office Report to Congressional Requesters June 2011 FRAUD DETECTION SYSTEMS Centers for Medicare and Medicaid Services Needs to Ensure More Widespread Use GAO-11-475

More information

Program Evaluation Oversight Committee

Program Evaluation Oversight Committee Program Evaluation Oversight Committee Government Data Analytics Center North Carolina Office of Information Technology Services GDAC Director: John Correllus OFFICE OF INFORMATION TECHNOLOGY SERVICES

More information

THE KEY ADVANTAGES OF BUSINESS INTELLIGENCE AND ANALYTICS

THE KEY ADVANTAGES OF BUSINESS INTELLIGENCE AND ANALYTICS THE KEY ADVANTAGES OF BUSINESS INTELLIGENCE AND ANALYTICS With the help of business intelligence solutions, organizations can implement corrections and take necessary measures to improve efficiency in

More information

Secondary Department(s): Corporate Investigations Date Policy Last Reviewed: September 28, 2012. Approval/Signature:

Secondary Department(s): Corporate Investigations Date Policy Last Reviewed: September 28, 2012. Approval/Signature: Subject: OBE-9 Fraud, Waste, and Abuse Detection and Prevention in Health Plan Operations Primary Department: Office of Business Ethics Effective Date of Policy: September 26, 2008 Plan CEO Approval/Signature:

More information

Kimberly Anne Bliss, M.S.W., J.D. 2790 A.J. Henry Park Drive Tallahassee, Florida 32309 Home: (850) 309-1011 Cell: (850) 510-8489 kbliss@thomasu.

Kimberly Anne Bliss, M.S.W., J.D. 2790 A.J. Henry Park Drive Tallahassee, Florida 32309 Home: (850) 309-1011 Cell: (850) 510-8489 kbliss@thomasu. ACADEMIC PREPARATION: Kimberly Anne Bliss, M.S.W., J.D. 2790 A.J. Henry Park Drive Tallahassee, Florida 32309 Home: (850) 309-1011 Cell: (850) 510-8489 kbliss@thomasu.edu J.D. in Law, Florida State University,

More information

Making Critical Connections: Predictive Analytics in Government

Making Critical Connections: Predictive Analytics in Government Making Critical Connections: Predictive Analytics in Improve strategic and tactical decision-making Highlights: Support data-driven decisions. Reduce fraud, waste and abuse. Allocate resources more effectively.

More information