Medicare anti-fraud system launched

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By William E. Gibson, Washington Bureau

4:32 p.m. EDT, July 10, 2011
WASHINGTON—
Using South Florida as a trailblazer, federal officials launched a nationwide computer system this month to spot suspicious Medicare claims and try to prevent billions of dollars from flowing to criminal enterprises.

It works much like credit-card systems that raise alerts about suspicious purchases — such as 20 pairs of shoes or unusually large sales — to help block criminals from using stolen cards or IDs.

Called "predictive modeling," the new federal system will examine the millions of Medicare claims filed each day to look for signs of fraud while factoring in warnings from tipsters and a database of suspects.

http://www.sun-sentinel.com/health/fl-medicare-fraud-predictive-model-20110708,0,3903538.story