NEWS
The US Justice Department reached a $1.5M fraud settlement involving lab marketers, companies, and doctors. The scheme centered on kickbacks to doctors in exchange for unnecessary tests billed to Medicare. Parties tried to hide the kickbacks as legitimate fees.
Source: NJ NEWS
SITUATION ANALYSIS
This case highlights the problem of healthcare fraud in the US. These schemes often use complex tactics to cheat insurers and government programs. This harms the healthcare system and wastes taxpayer money. Investigating healthcare fraud is difficult because criminals work hard to hide illegal financial deals.
CHALLENGES
Uncovering Kickbacks: Investigators must carefully sift through complex financial records to find disguised kickback schemes.
Identifying Participants: Fraud networks often involve many people and entities, making it hard to uncover everyone involved.
Securing Evidence: Building a strong case needs clear evidence to prove intent to defraud and connect specific actions to fraudulent claims.
WHY iCOGNATIVE?
iCognative™ is a powerful investigative technology that identifies hidden knowledge within a suspect’s brain. Authorities input confidential details and by strategically presenting that information as phrases or pictures, iCognative™ can identify whether that information is familiar to the suspect. In complex healthcare fraud cases, iCognative™ could prove invaluable.
Network Exposure: Identify connections within the fraud scheme by testing suspects’ reactions to key individuals, entities, or coded terminology.
Financial Tracking: Detect familiarity with suspicious transactions, locations, or financial patterns tied to fraudulent activity.
Deception Detection: Reveal knowledge of methods used to conceal kickbacks, manipulate records, or justify unnecessary procedures.
iCognative™ testing could speed up healthcare fraud investigations and save up to 80% on time and resources.
Source: Brainwave Science