Challenge

Charged with overseeing the Program Integrity of the Medicare and Medicaid Programs, our client is committed to combating Medicare and Medicaid provider fraud, waste, and abuse.  These activities divert critical federal health funding that could otherwise be spent on safeguarding the health and welfare of U.S. Citizens and enrollees.

Our client faces new and continually evolving threats to Government Program Integrity.  This necessitates that they work with a firm, like Analytica, that understands how to provide value-based innovation and is able to apply solutions that incorporate efficient data management, leverage big data, modeling, data science and advanced fraud analytics to help combat fraud, waste, abuse and improper payments.

Results

As fraud, waste and abuse methods have evolved, Analytica has helped our client combat these challenges through maintaining Medicare and Medicaid Insurance Program Integrity.  Through our work supporting this client, they have been able to identify new patterns and fraud methods, recover millions of dollars, and work  the Department of Justice to prosecute various illicit criminal networks.  Analytica’s collaborative and impartial approach has allowed us to become a trusted partner for our client as well as other Government Agencies in charge of protecting Program Integrity.