“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.”
“The Securities and Exchange Commission has charged that six expert network consultants and employees illegally tipped hedge funds and other investors to generate nearly $6 million in illicit gains… The SEC alleged that four technology company employees, while moonlighting as consultants or ‘experts’ to Primary Global Research LLC (’PGR’) without the knowledge of their employers, abused their access to inside information about such technology companies as AMD, Apple, Dell, Flextronics, and Marvell. The consultants received hundreds of thousands of dollars in purported consulting fees from PGR for sharing the inside information with PGR employees and clients, according to the SEC.”
“Clark said people have come up with clever ways to file fraud claims by staging accidents where everyone in the accident is part of it and they try to get some sort of disability payment.”
“Topping the list are Miami brothers Carlos, Luis and Jose Benitez. Owners of a string of medical clinics, they allegedly scammed Medicare out of $119 million by billing for costly HIV drugs that patients never received or did not need. Authorities say they bought hotels, helicopters and boats before fleeing to Cuba.”
“Companies worldwide have seen an increase in fraud due to ineffective internal controls, according to a report issued by Deloitte yesterday… a significant percentage of companies (51%) recognised they did not have sufficient numbers of trained staff to provide effective assurance on fraud risk in their organisations, with smaller businesses finding themselves even more constrained.”
Westminster Group PLC (LON:WSG) said it has secured distribution rights in the UK and the Middle East for the identity fraud detection software of Texas-based Infoglide Software. The commercial details of the deal were not disclosed. Westminster expects the product to be popular with national security agencies across the Middle East in particular. Infoglide’s identity resolution technology searches, matches and links entities across multiple, disparate data sources using over 50 algorithms.”
“Dr. Wayne, a 50-year-old osteopath, denies abusing the system and hasn’t been accused of wrongdoing by authorities. He says his regimen ‘does wonders’ if used correctly. He adds that he gave physical therapy to ‘patients who needed it, with appropriate diagnoses, and I should get paid for it.’ Medicare administrators apparently felt otherwise. In 2009 he says he was placed on heightened scrutiny and eventually sold his business. But not until he had received more than $2.6 million from Medicare between 2007 and 2009, according to the person familiar with the matter.”
“Unlike oil reserves, data is an abundant resource on our wired planet. Though much of it is noise, at scale and with the right mining algorithms, this data can yield information that can predict traffic jams, entertainment trends, even flu outbreaks. These are hints of the promise of big data, which will mature in the coming decade, driven by advances in three principal areas: sensor networks, cloud computing, and machine learning.”
“Specifically, on October 1, 2009, MARTINEAU purchased a residence at 211 Lloyd Street in New Haven after working with others to obtain an FHA-insured loan to buy the house at the fraudulently inflated price of $160,000. The loan package for this transaction included false information about the MARTINEAU’s employment, assets and liabilities, and MARTINEAU’s intention to occupy the property as her principal residence. The loan application also was supported by false documentation, including earning statements and fraudulent bank records.”
“The buyer redeemed the ticket later at the outlet in Burlington and wasn’t told that he won a free ticket, investigators determined, according to the CBC. That ticket went on to win a $12.5 million jackpot. It was claimed by Kathleen Chung, sister and daughter of men who worked at the outlet.”
“The current hype around ‘big data‘ has caused some analysts and vendors to declare the death of data warehousing, and in some cases, the demise even of the relational database. A prerequisite to discussing these claims is to understand and clearly define the term ‘big data.’ However, it’s a fairly nebulous concept.”
“In addition, the Medicare Fraud Strike Force has been extended to seven cities. Using advanced data analysis techniques to identify high billing levels in healthcare fraud hot spots, the interagency teams can target emerging or migrating schemes along with chronic fraud by criminals masquerading as healthcare providers or suppliers.”
“Florida CFO Jeff Atwater announced the arrest of David Rodriguez-Socarras, who officials allege used a ’shell’ company and fictitious name in order to cash nearly $3 million in payroll checks through a money service business to avoid workers’ compensation premiums and payroll taxes.”
“By 2013 the amount of traffic flowing over the internet annually will reach 667 exabytes, according to Cisco, a maker of communications gear. And the quantity of data continues to grow faster than the ability of the network to carry it all.”
“The federal government pointed to the expansion of Medicare Fraud Strike Force teams as one reason for the increased recovery. In FY 2010, the total number of cities with strike force prosecution teams was increased to seven, all of which have teams of investigators and prosecutors dedicated to fighting fraud. The strike force teams use advanced data analysis techniques to identify high-billing levels in health care fraud hot spots so that interagency teams can target emerging or migrating schemes along with chronic fraud by criminals masquerading as health care providers or suppliers.”
“MDM is the latest attempt to solve the old problem of inconsistent versions of important data at the centre of an organization,” said Andrew White, research vice president at Gartner. “As with any new initiative, there is a lot of hype and confusion, and with hype and confusion comes misunderstanding. Executive sponsors of MDM and MDM program managers must avoid several common mistakes that have been known to derail MDM initiatives in the past.”
“The report notes that by 2020, much of this data will be held in cloud environments or will be “touched by cloud,” which means data that transits through a cloud service or is temporarily held in a cloud application. The report estimates that perhaps 15% of all data will be held in the cloud, and that around one-third will live in or pass through the cloud.”
“We talked a week ago about the rapidly emerging market space called Big Data. One statistic that opened my eyes is Gartner’s prediction that the volume of new data generated by enterprises will grow by 650% in the next five years, and 80% of that will be unstructured data! The 451Group’s definition of Big Data describes a growing need for non-traditional processes that can treat massive amounts of data as a whole, thereby making it impossible to use many traditional tools and techniques.”
“These tools will integrate many of the agency’s pilot programs into the National Fraud Prevention Program and complement the work of the joint HHS and Department of Justice Health Care Fraud Prevention and Enforcement Action Team (HEAT). ‘Preventing fraud is more effective than the old ‘pay and chase’ model of fighting fraud after a sham provider has been paid and disappeared,” CMS administrator Donald Berwick said in a statement. “By using new predictive modeling analytic tools we are better able to expand our efforts to save the millions — and possibly billions — of dollars wasted on waste, fraud, and abuse.’”
“Concerns that internal initiatives, and the CIO’s clout, will be gutted and most funds redirected to the cloud are overstated–for now. But we are at an inflection point: IT has money to spend, but it can’t be allocated using the same old budget process that’s kept us in a rut of dedicating a third or more of our resources to keeping the lights on. Business leaders have little patience for high-priced, long-term IT slogs. They’ve seen massive 18-month projects fail and experienced success with lightweight software-as-a-service offerings. CIOs must look at each expenditure and think, ‘Will this buy us flexibility and advance the business?’”
“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.”
“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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