Medicaid fraud is identity fraud – often the same doctors, chiros, lawyers found in Medicaid fraud rings are the same ones we find in insurance fraud.
The big Medicaid fraud comes from organized rings – doctors, lawyers, transportation providers, medical equipment companies.
Organized white collar crime is a repeat business. Scammy doctors organize patients who file false claims and get paid a pittance for each claim. The doctor, never performing the treatments takes the money and the state and its citizens have been ripped off.
We started doing Medicaid fraud work in 1999. Back then, the computer power to do the cross database search was overwhelming. We cross searched patient records, tied them with doctors, then ran known fake addresses like UPS boxes – and found major rings.
With Fractal, the compute cost and necessary power disappear.
Today Fractal can take every state and federal data roll – some not relating to Medicaid – and reconcile them against each other. This is economically impossible with any current technology. It would cost tens of millions of dollars, take years to build.
Fractal = 90 days! Maybe less.
Finding hidden relationships among people who change their names or addresses happens so fast with Fractal, law enforcement can quickly see where to investigate.
Fractal is working with legislators in several states to demonstrate how to process massive Medicaid claims databases to show law enforcement previously elusive connections.