How Advanced Analytics Can Prevent Medicaid Fraud

Discussion Overview

Medicaid fraud is prevalent, costly, and difficult to prevent. With a combination of more integrated data and advanced analytics, state agencies have the opportunity to turn the tables on fraudsters. They can accelerate the transition from detection to prevention, as new forms of fraud are recognized faster and fewer improper payments go out the door. To explore the challenges and opportunities, IIA spoke with SAS Institute’s Ellen Joyner-Roberson, CFE Principal Marketing Manager, Fraud and Security Intelligence, and Victor Sterling, Principal Solutions Architect.

How big is the Medicaid fraud problem, and why is

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