“In ‘Mining the Tar Sands of Big Data’, Matthew Driscoll and Roger Ehrenberg draw an apt parallel between the earth’s vast oil reserves and big data: until recently it wasn’t economically and technically feasible to mine these resources efficiently. In both cases, that’s changing.”
“It’s obvious that Medicare’s and Medicaid’s default button is set to ‘pay the claim’ instead of seeking more complete verification that the patient needed the benefit or actually received it. There is no other way people could rip off the agencies for so much money - like the three brothers from Miami suspected of fraud for $119 million worth of billing for HIV drugs before reportedly fleeing to Cuba.”
“‘Terrorism is a threat to Arizona as much or more than many states because of our size, and critical industries we have here.’ Roughly 200 people work there, including FBI agents, Homeland Security agents, and police officers from different departments around Arizona. They analyze tips and track down leads, anything having to do with potential terrorist activity.”
“When I explain to people why the Big Data movement is important — why it’s a real change instead of a fad — I point to price as the fundamental difference between the old and new worlds. Until a few years ago, the state of the art for doing meaningful analysis of multi-gigabyte data sets was the data warehouse. These custom systems were very capable, but could easily cost millions of dollars. Today I can hire a hundred machine Hadoop cluster from Amazon for just $10 an hour, and process thousands of gigabytes a day.”
“What is entity identity management? It simply means that an ER system can store and maintain a record of identity information that persists over time. Entity identity management is essential for an ER engine to operate in identity resolution or identity capture mode and for it to maintain persistent entity identifiers.”
“Why are they moving to the cloud? Rarely because it’s considered cheaper. In some cases, the cloud represents a faster, more flexible way to get a new system up and running. Oftentimes, it’s the ease of integration afforded by the cloud servers, using standard Web service practices, that lets a company launch a new mobile application faster or run a business process that cuts across many partners more efficiently.”
“A little over a year ago, Rand Corporation said that the Unique Patient Identifier would cost $11 billion, and pay off nationwide in reducing these sorts of medical errors, and in simplifying the nationwide effectiveness of the Electronic Health Record (EHR), which in turn can introduce a high level of efficiency, and a way to enforce patient privacy.”
“Enrollment in Personal Care Service requires approval from a qualified health care professional. This approval is missing in the cases of a ’substantial percentage’ of the 17,500 individuals who have received 24-hour care since 2000, claims the lawsuit. The lawsuit lists several examples of patients allegedly not properly assigned to the Personal Care Service. A 65-year-old woman was deemed to only need limited care, being of sound mind and body. Instead, she was provided with 24-hour care on the federal government’s bill.”
“A total of 389 guards and other workers have filed more than 500 claims, including about 290 still pending. About 230 of these claimed injury for the underlying cause of ‘repetitive trauma,’ including carpal tunnel syndrome, an injury of the wrist. The prison employs about 760 workers, of which 567 are guards. ‘The Department of Insurance is investigating recent questions raised in connection with workers’ compensation claims filed against the state of Illinois at the Menard Correctional Center,’ department spokesman Louis Pukelis said Tuesday in a written statement.”
“As states and localities have put up fusion centers designed precisely to overcome this, however, they’ve had to face a different challenge: ensuring not only the quantity but the quality of information they collect and report. In candid conversations with Homeland Security Today, leading privacy advocates, scholars and state law enforcement and federal officials addressed some of the key facets of this challenge, as well as steps that can be taken to ensure that fusion centers live up to their full potential as a counterterrorism tool.”
“North Carolina’s Medicaid fraud investigators pulled in millions last year through dozens of cases of fraud and patient abuse, the state’s attorney general’s office reported Monday. The office’s Medicaid Investigations Unit prosecuted 22 criminal convictions and 18 civil settlements, recovering $53.5 million, during the federal fiscal year that ended Sept. 30, according to a press release from N.C. Attorney General Roy Cooper.”
“Needless to say, it’s a huge deal. Gartner recently put cloud computing at the top of its list of top strategic technologies for 2011 and it’s far from the only expert extolling the glory of the Web-hosted software and infrastructure. For small businesses, the significance of this primarily comes down to cost. In many cases, using cloud-based infrastructure is cheaper than running and maintaining one’s own physical servers.”
“Strategic decisions about cloud computing should both draw upon and inform the EA. An organization must have a mature and well formed understanding of its architecture components (e.g., business processes, services, applications and data) to make meaningful decisions related to cloud computing, such as whether a move to the cloud is advantageous, what services most lend themselves to a cloud deployment, and what cloud deployment model (e.g., private, public) makes the most sense. There are three key roles for EA in facilitating cloud computing strategy and planning…”
“‘Medicaid cheaters rob taxpayers, hurt needy patients and push medical costs higher for all of us,’ Cooper said in a statement. ‘We’re stopping the waste and abuse and making violators pay.’ During the federal fiscal year that ended Sept. 30, the Medicaid Investigations Unit of the state Attorney General’s Office won 22 criminal convictions and negotiated 18 civil settlements worth $53.5 million.”
“Under Secure Flight, the Transportation Security Administration (TSA) prescreens passenger name, date of birth and gender against terrorist watchlists before passengers receive their boarding passes. In addition to facilitating secure travel for all passengers, the program helps prevent the misidentification of passengers who have names similar to individuals on government watchlists. Prior to Secure Flight, airlines held responsibility for checking passengers against watchlists.”
“Professional analysts and law enforcement officers from more than 15 different agencies including the FBI, ATF, DEA, US Marshall’s, Homeland Security, and state and county partners work from one large room to put out intelligence products in a truly collaborative environment that defines New Jersey’s fusion center. Products include crime mapping with predictive analysis to help local departments know when and where crimes are likely to occur in the future.”
“Morgan’s prison sentence will be followed by three years of supervised release. Morgan was ordered to pay restitution of $2,804,462. Morgan, 64, was convicted in October 2008, of 69 counts of health care fraud, following a two-week jury trial in Albany. Michael J. Moore, U.S. attorney for the Middle District of Georgia, said the indictment charged that for a period of several years ending in August 2007, Morgan, a registered pharmacist and the owner of Thrift Center Pharmacy in Camilla, executed a scheme to defraud the Georgia Medicaid program, which is jointly funded with state and federal funds.
“TCSPs are often involved in some way in the establishment and administration of most legal persons and arrangements; and accordingly in many jurisdictions they play a key role as the gatekeepers for the financial sector. This report provides a number of case studies which demonstrate that TCSPs have often been used, wittingly or unwittingly, in the conduct of money laundering activities.”
“Early this year, Gartner suggested that a ‘data deluge’ has begun. In his recent Dataspora Blog post about ‘Big Data’ and what it means, author Michael Driscoll presents a unique and interesting perspective on the massive amounts of data being generated and stored. According to The 451 Group’s definition…”
“Gartner released a report in November entitled, ‘Top 10 Technology Trends Impacting Information Infrastructure, 2011.’ Two of the top ten trends were ‘Entity Resolution and Analysis’ and ‘Master Data Management.’”
“According to Taxpayers Against Fraud, a nonprofit group based in Washington, D.C., National Medical then launched a campaign to force Ven-A-Care out of business. But in fighting back, Ven-A-Care staff discovered National Medical was paying kickbacks to doctors who prescribed medicines and services that weren’t needed, then billing Medicare and Medicaid exorbitant sums far in excess of what the medicines and services cost. The Justice Department eventually got a $486 million settlement from National Medical — and Ven-A-Care received $40 million as its reward under the False Claims Act.”
“Russian financial institutions reported 120 trillion roubles (2.44 trillion pounds) of suspicious transactions to the anti-money laundering watchdog in the first nine months of 2010, the Kommersant daily reported on Monday.”
“Immediately after the Christmas bomber incident in 2009, we highlighted the positive role that broader deployment of (id)entity resolution software could play in preventing terrorist actions. That thought was seconded this week in a piece published by the Canadian Broadcasting Company (CBC) entitled ‘Better data analysis for a safer world’…”
“According to the same official statement, Louisiana doled out more than $850 million in taxpayer funds to drug companies to pay for drugs between 1991 and 2009. But a significant portion of this amount was most likely fraudulent because of the billing scheme drug companies utilize to get reimbursed. The way it works is drug companies report what are called the Average Wholesale Prices (AWPs) for drugs, and are subsequently reimbursed by state Medicaid programs for these amounts. But the lawsuit alleges that drug companies were marking up these costs as high as 6000 percent above actual costs.”
“Last month a father and son who worked at Burlington store were charged, along with another family member, with stealing a $12.5-million Super 7 jackpot in 2003. The case has not yet come to trial. Mr. Vikoren said that for membership cards to ensure consumer protection, people need to keep their card safe.”
“But the whole thing made me think about whether the TSA could institute a ‘trusted traveler’ program that allows vetted frequent flyers easier access through security. It’s an idea supported by the U.S. Travel Association. The organization, which promotes the interests of the travel industry, has called upon the government to consider such a measure, especially because the Department of Homeland Security is already working with airlines and online reservation systems on Secure Flight, where manifests of domestic and inbound passengers are checked against government watch lists.”
“Even if EHRs reduce the risk of errors overall, they may produce entirely new ones, Edward Fotsch, CEO of PDR Network, which will provide network operations for the new reporting system, tells the Health Blog. For example, EHRs may cut the risk of failing to alert a patient to an abnormal test result, but confusing user interfaces may produce their own mistakes and need tinkering.”
“Even with these differences, a human can rapidly determine that they refer to the same individual for two reasons. The first is that the values that differ across the pair of records are not too different from each other, and the second is that there seems to be enough support from across each pair of attributes to assert some degree of similarity.”
“According to the Centers for Medicare and Medicaid Services, the program made nearly $24 billion in improper payments in 2009, almost doubling the previous years’ rate. The price of fraud, however, runs even higher. A CBS report notes that Medicare fraud costs taxpayers an estimated $60 billion a year, and some estimates put the figure at nearly $100 billion.”
“For the last two years, respondents to our survey have cited several information management-related problems among the top barriers to adopting BI tools company-wide. Data quality problems are cited most often, by 55% in both 2009 and this year, followed by ease-of-use challenges, and integration and compatibility with existing platforms. Among the people directly responsible for information management, the biggest impediments to success are accessing relevant, timely, reliable data (59%); cleansing, deduping, and ensuring consistent data (51%); and integrating data (49%).”
“Billions of your tax dollars are lost every year to healthcare fraud. In fact, the tab is $36Million a day for Medicare fraud alone. U.S. Congressman Michael Burgess of Lewisville watched FOX 4’s undercover investigation in to the practices of a home health care recruiter. Today, FOX 4’s Becky Oliver spoke with Congressman Burgess.”
“In just the last fiscal year, we obtained settlements and judgments of more than $2.5 billion in False Claims Act matters alleging health care fraud. This marked a new record – and an increase of more than 60 percent from fiscal year 2009. We also opened more than 2,000 new criminal and civil health-care fraud investigations, reached an all-time high in the number of health-care fraud defendants charged, stopped numerous large-scale fraud schemes in their tracks, and returned more than $2.5 billion to the Medicare Trust Fund and more than $800 million to cash-strapped state Medicaid programs.”
“Gartner reports that due to the sluggish economy, customer demand for MDM software is growing at a significantly slower rate than years past. But it is growing. The analyst firm predicts that the overall market for MDM software will increase from $1 billion in 2008 to $2.9 billion by 2013. Gartner also predicts that by 2010, investments in MDM software will lead to an 80% reduction in costs associated with managing redundant data.”
“Some of the nation’s 72 fusion centers–where federal, state, and local law enforcement agencies share data on terrorism and crime threats–may face budget problems in the nation’s tough economic conditions. Ross Ashley of the National Fusion Center Association, which represents the centers, says that some newly elected governors must be convinced of the centers’ worth. The agencies typically do not have line-item budgets and are dependent on allocations from various levels of government to operate.”
Infoglide Software provides entity resolution and analysis solutions for retail, banking, insurance, government, and law enforcement. Without the need for data cleansing or warehousing, Infoglide Software's Identity Resolution Engine™ (IRE) analyzes all of the information relating to individuals and/or entities from multiple sources of data and then applies...
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