Identity Resolution Daily

By the Infoglide Team

Bloomberg: Banks Financing Mexico Gangs Admitted in Wells Fargo Deal

“Wachovia admitted it didn’t do enough to spot illicit funds in handling $378.4 billion for Mexican-currency-exchange houses from 2004 to 2007. That’s the largest violation of the Bank Secrecy Act, an anti-money-laundering law, in U.S. history — a sum equal to one-third of Mexico’s current gross domestic product.”

HIMSS: Informed Patient Identity Solution

“The identification of the patient is not always accurate in healthcare. Information for one individual may exist in one or multiple databases where it resides as ‘duplicate,’ inaccessible or unknown to those needing to see the complete or most current picture. Due to administrative errors, information on two different individuals can be ‘overlaid’ and presented as one person’s record. Linking the wrong clinical information to a person not only can cause great personal harm to the patient, but also can incur huge costs to the healthcare provider in correcting and mitigating the error.”

ExecutiveGov: Napolitano Announces Progress in 9/11 Commission Security Recommendations

“‘By working with our partners across the globe, we have achieved historic advances in international aviation security – including bolstering explosives detection, strengthening the vetting of passengers against terrorist watchlists, refining passenger screening techniques and deploying tens of thousands of trained aviation security personnel—that make air travel safer for everyone.’ Among other things, the report showed that aviation security received a large boost with the implementation of Secure Flight for 100 percent of passengers flying domestically and internationally on U.S. airlines.”

ERIQ: 15th Annual ICIQ Conference in Little Rock, AR, November 12-14, 2010

“The Donaghey College of Engineering and Information Technology at the University of Arkansas at Little Rock (UALR) will host the 15th International Conference on Information Quality  (ICIQ) on November 12-14, 2010.  The  ICIQ attracts researchers and practitioners in the academic, public and private sectors from across the globe.”

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By Mike Betron, Infoglide Software Director of Marketing

More than half of the $98 million in “improper payments” by the federal government in 2009 were made through Medicare and Medicaid. A recent article in the New England Journal of Medicine points out that “since 1990, the Government Accountability Office (GAO) has designated Medicare as a high-risk federal program because its vast size and complexity make it vulnerable to fraud, waste, and abuse.” The article goes on to discuss how to combat the fraud through better screening.

“Increasingly, federal investigators have found that the Medicare system is being infiltrated by criminals and organized criminal networks.” One solution suggested is “imposition of more stringent entry requirements on the 18,000 applicants who, in an average month, seek Medicare’s approval to bill the program for service.” Every day, identity resolution software screens every airline passenger on every U.S. domestic flight to detect known criminals and terrorists. Could the same technology screen 18,000 new healthcare program applicants every month?

The article suggests that the Department of Health and Human Services (DHHS) be empowered “to determine which Medicare providers should create internal compliance programs designed to make them more vigilant against fraud.” Today, banks and insurance companies are using identity resolution software to detect the social networks of fraud rings. Could the same technology with its similarity searching and hidden identity detection form the core of a new system that screens internal activity to monitor compliance?

“Kimberly Brandt, director of the CMS’s program-integrity group, emphasized that the newly granted authority would enable the agency to move away from its historical ‘pay and chase’ mode to focus greater resources on fraud prevention.” Every day, identity resolution software screens every airline passenger on every U.S. domestic flight to prevent known criminals and terrorists from boarding airplanes without being detected. Could the same technology be used to make the whole Medicare and Medicaid infrastructure more proactive in preventing fraud?

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[Post from Infoglide] Workers Compensation Budget Impact

“A recent article written by IAIABC Executive Director Greg Krohm does a great job of analyzing the effects that the Patient Protect and Affordable Health Care Act of 2010 (aka Obamacare) and the American Recovery and Reinvestment Act of 2009 are expected to have on the cost and administration of workers’ compensation programs. The indirect impact of the budgetary pressure put on state government budgets by the new federal requirements is troubling…”

The New England Journal of Medicine: The ACA’s New Weapons against Health Care Fraud

“Among the most immediate changes will be more rigorous screening procedures for applicants seeking Medicare’s approval to bill the program for services. The law grants the DHHS broad discretion to subject applicants to criminal background checks, fingerprinting, unannounced site visits, and database checks.”

The TSA Blog: Secure Flight Q&A

“TSA collects as little personal information as possible to conduct effective watch list matching. Also, personal data is collected, used, distributed, stored, and disposed of in accordance with stringent guidelines and all applicable privacy laws and regulations.”

Ezine Articles: Tutorial on Workers’ Compensation

“Surprisingly, it’s employer fraud that is the major type of workers’ comp fraud. According to a recent study reported by the National Commission on State Workmen’s Compensation Laws, over 13% of employers studied were operating without legally required workers’ compensation insurance. In addition, others were found to be cheating the system by intentionally misclassifying or underreporting their payroll or by falsely representing employees as independent contractors.”

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[Post from Infoglide] Reference Linking Methods - Part 2

“In the last post we discussed methods for linking references that I classified into the four categories of:

1. Direct matching
2. Transitive linking
3. Linking by association
4. Asserted Linking

In the last post the focus was on direct matching, which is what most people think of when the topic of entity resolution (ER) comes up.”

mySAnews: Refugees were pawns in fraud case

“They were investigating allegations that Abdirahman’s visitor, local pharmacist Marcelleus J. Anunobi, had been soliciting people for similar information that the agents say he used to commit up to $2.5 million in Medicaid fraud. Abdirahman is one of several people subpoenaed this week to testify in the case of Anunobi, who since 2007 owned the now-closed Advanced Doctor’s Prescribed Pharmacy on Medical Drive.”

The TSA Blog: Secure Flight: TSA Now Performing 100% Watchlist Matching for Domestic Flights

“What is watchlist matching? It’s when a passenger is prescreened using their name, date of birth and gender (that should match the information on their approved official government ID) against government watchlists for domestic and international flights. Actual names on the list are identified by the FBI’s Terrorist Screening Center as being people who may pose a known or suspected threat to aviation.”

Insurance & Financial Advisor: N.Y. State Insurance Fund issues annual report

“The NYSIF said it conducted 16,422 safety surveys and 2,228 safety training presentations for policyholders during the year. Its anti-fraud efforts  saved an estimated $16.6 million and led to 154 arrests, 1,246 investigations and 584 cases referred for prosecution.”

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By the Infoglide Team

TribStar.com: Doctor indicted on federal fraud charges

“The indictment alleges that Tiwari defrauded health care benefit programs including Medicare, Indiana Medicaid and Anthem Blue Cross Blue Shield, and that from 2002 through 2007, he was paid more than $21 million by those three programs alone. Tiwari does business as The Pain Management Center of Southern Indiana P.C., The Pain Management & Surgery Center of Southern Indiana Inc., and Southern Indiana Anesthesiology P.C., formerly known as Kamal Tiwari Inc. P.C.”

HSToday: TSA’s Secure Flight Hits 100 Percent Mark

“All passengers flying domestically and internationally on US airlines are now being checked against government watch lists through the Transportation Security Administration’s (TSA) Secure Flight program, DHS Secretary Janet Napolitano announced late last week… TSA began implementing Secure Flight in late 2009 and expects all international carriers with direct flights to the United States to begin using Secure Flight by the end of 2010.”

Government Security News:  Using good technology to find bad people

“Gartner, a highly regarded research firm and consultancy organization, has been tracking the entity-resolution market for several years and stated in a recent report: ‘Entity resolution and analysis was previously an obscure technology that has come to the forefront as a result of world events and market forces where it is used to identify the use of false identities and networks of individuals who are attempting to hide their relationships to each other.’”

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[Post from Infoglide] Insider Collusion

“Stories about financial services fraud are on the rise. Consider the recent article about an employee of a financial services company who had charges filed against him for conspiring to rig bids for investments in municipal bond projects…”

SafetyAtWorkBlog: OHS regulator reveals a blog about OHS fraud and crime

“For the last couple of months, Washington State’s Department of Labour & Industries has been running a blog written by its Fraud Prevention and Compliance Manager, Carl Hammersburg.  The blog matches the remit of the regulatory authority and covers a range of industrial enforcement actions.  Occasionally it has included its own video surveillance  of potential workers’ compensation fraudsters.”

Financial Fraud Law: Guilty Plea By Former Financial Services Employee In Muni Bond Bid-Rigging And Fraud Conspiracy

“According to court documents: Zaino engaged in a bid-rigging conspiracy from at least as early as October 2001 until March 2006.  As a part of the bid-rigging conspiracy, Zaino, acting as a broker of investment agreements, and co-conspirator providers designated in advance which co-conspirator provider would be the winning bidder for certain investment agreements brokered by Zaino’s employer.”

TravelDailyNews: ASTA works with TSA on secure flight compliance

“‘ASTA has and will continue to work closely with the TSA to notify members through member alerts and updates, of upcoming changes and deadlines that impact the travel agency community and the traveling public. We have, throughout the implementation period, met with TSA and provided updates and direction to our members regarding compliance,’  said ASTA President and Chair Chris Russo.”

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By the Infoglide Team

Homeland Security: Secretary Napolitano Announces Major Aviation Security Milestone

“Department of Homeland Security (DHS) Secretary Janet Napolitano today announced that 100 percent of passengers traveling within the United States and its territories are now being checked against terrorist watchlists through the Transportation Security Administration’s (TSA) Secure Flight program—a major step in fulfilling a key 9/11 Commission recommendation.”

NaplesNews: New Gulf Coast ‘fusion center’ creates 10-county law enforcement initiative

“The center, which is housed in the FBI’s Fort Myers office near Gateway, is designed to digest and compare data from across the region. Once complete, Storrar said the center will help local officials bridge jurisdictional, historical and technological barriers. It will help law enforcement, fire and health officials look for red flags, connect dots and provide threat assessments, Storrar said.”

WSJ: Loopholes Allow Tainted Money Into U.S., Report Says

“In the case of Teodoro Nguema Obiang Mangue, the son of the president of Equatorial Guinea, the report said two lawyers helped him bypass anti-money-laundering laws by allowing him to use shell company accounts as conduits for his funds without telling U.S. bankers that Obiang was using the accounts. ‘If a bank later uncovered Mr. Obiang’s use of an account and closed it, the lawyers helped him set up another,’ it said.”

California Healthline: California Organizations Nab $18.46M in Health IT Stimulus Funding

“Officials said health care providers at the centers who demonstrate ‘meaningful use’ of EHRs could be eligible for federal incentive payments through Medicaid and Medicare.”

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Identity Resolution Daily Links 2010-05-29

[Post from Infoglide] Reference Linking Methods - Part 1

“In the last few posts, we reviewed the basic architectures used to implement entity resolution (ER) systems.  Although this gives us the big picture at the systems level, ER really takes place at the reference (record) level where the system must ultimately decide whether two references are for the same or for different real-world objects, i.e. to link or not to link.  In this series I’ll discuss some of the most common methods for making these linking decisions.”

P&C National Underwriter: New York City Listed As No.1 In Staged Auto Accident Fraud

“NYAAIF noted that the New York-based Insurance Information Institute reported that fraud and abuse in the New York no-fault system accounts for roughly 20 percent of every no-fault claim paid—or about $1,561 per claim. Spread across the state, that amounted to nearly $230 million in ‘fraud taxes’ in 2009, according to the Alliance.”

Bank Info Security: 6 Signs of Business Loan Fraud

Three states (Wyoming, Nevada and Delaware) do not require any proof of identification to set up a business. Another 26 states allow a limited liability corporation (LLC) to be set up without showing beneficial ownership. ‘When banks try to cross-reference within their own business customers, they’ll find the connection,’ she says. ‘But when they distribute it across several banks, it’s not clearly visible. It’s hard to do pattern relationships because banks don’t compare notes, so that’s how [the fraudsters] dilute and avoid detection.’”

GovMonitor: Homeland Security Outlines 2010 Summer Travel Tips

“The Secure Flight watch-list matching process occurs before a passenger even gets to the airport so if you get a boarding pass, the Secure Flight matching process is done. In other words, you are clear once you get that pass.”

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By the Infoglide Team

Consumer Traveler: TSA announces Secure Flight will be complete within a month

“Speaking at U.S. Travel Association’s Pow Wow conference to encourage foreign tourism, Leyh noted that TSA is about to complete their mission of taking back the watchlist matching. This is part of maintaining control of the actual list for security and of relieving the airlines of the responsibility of performing the matches prior to allowing passengers to board.”

iHealthBeat: Reform Law Calls for Use of New Technology To Fight Medicare Fraud

“At the report’s release, HHS and Department of Justice officials said a new CMS program called the Center for Program Integrity would help implement the anti-fraud provisions of the reform law by using sophisticated techniques to uncover improper payments. Officials said CMS also would work with the private health care sector to combat fraud.”

Journal of Online Business: What Is There To Learn About Cloud Computing?

“One big advantage to a small business of accessing only what is needed at the time that it is needed is that initial capital outlay for end user licenses, individual work stations, and the like is considerably reduced. Thus there is little reason to outright purchase something that is merely required for special circumstances, monthly, or year end reports.”

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By the Infoglide Team

Media Health Leaders Media: Detroit Doc Gets Six Years for Medicare Fraud

“Myint, of Bloomfield Hills, MI, was also ordered to pay more than $3.1 million in restitution, jointly with co-defendants, and to serve two years of supervised release following his prison term. Terrence Hicks, of Jackson, MI, the patient recruiter, was ordered to pay more than $4.9 million in restitution, jointly with co-defendants, and to serve three years of supervised release following his prison term.”

AolTravel: Is the No-Fly List Working?

“‘The TSA is hoping to smooth glitches with the new Secure Flight program — a system by which the ‘TSA will conduct uniform prescreening of passenger information against federal government watchlists,’ according to an official statement. ‘The TSA is taking over this responsibility from the airlines.’ The TSA says the Secure Flight system will be in effect for all domestic flights by mid-2010 and all international flights by the end of 2010, at which time the latest two-hour notification rule will become moot (since the airlines will no longer be responsible). Meanwhile, in the case of Shahzad, Kahn says it’s important to remember that the current system — for all its perceived faults related to his near escape — ultimately did what it was meant to do.”

ITBusinessEdge: Baby Steps to Master Data Management

“If you want to start small with master data management, you’ve got to start with a noun, says Evan Levy, a partner at Baseline Consulting  and an instructor with The Data Warehousing Institute… The problem is, IT doesn’t think in nouns. IT is all about the verb: Defining, coding, testing, supporting. What’s more, IT departments tend to view the world in terms of projects – fulfilling this feature request, upgrading to this release, migrating to this server.”

Liliendahl on Data Quality: Aadhar (or Aadhaar)

“In Denmark we have had such an identifier (one for citizens and one for companies) for many years. It is not used by everyone everywhere – so you still are able to make money being a data quality professional specializing in data matching. The main reason that the unique citizen identifier is not used all over is of course privacy considerations.”

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