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May 2012 Archives

New Software Used In Medicaid Fraud Investigations

North Carolina is one of many jurisdictions testing new methods to avoid overpaying for Medicare and Medicaid expenses. IBM has developed software that uses predictive analytics to unearth potentially fraudulent Medicaid payments. The fraud detection software analyzes millions of claims for Medicaid eligible patients and looks for billing patterns that have been identified as potentially fraudulent. The goal of the systems is generally to avoid approving improper payments rather than waiting to pursue civil remedies from hospitals, doctors and other health care providers for Medicare or Medicaid fraud after the money has changed hands.

Several government officials charged with drug trafficking

International drug trafficking cases can be very complex and involve many different parties. Oftentimes, after large-scale investigations, federal prosecutors will bring extensive federal criminal charges against anyone who is suspected of being involved in a drug smuggling conspiracy.

Woman who allegedly assisted suicides sentenced for tax evasion

Many times prosecutors in Florida will use evidence of fraud, such as mail fraud or tax fraud, in order to avoid having to prosecute someone on charges that are either more difficult to prove which have less likelihood of a conviction or which cannot be charged in federal court.

Woman Tried For Investment Fraud Sentenced To 35 Years

A Ponzi scheme netted a Florida couple some $28 million in profits from 87 victims. The white collar criminal case against the wife has led to a 35 year sentence in federal prison. This despite that fact that her husband, as well as several others recently convicted in similar, larger cases received significantly less prison time. A third person is facing charges in connection with the operation, but he remains outside the country and has yet to be extradicted.

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