2015 Annual Training Conference & Anti-Fraud Expo

Addressing Evolving Threats in Fraud, Waste and Abuse (Room Seaport A)

Fraud schemes are continuing to evolve at a staggering rate and the growing Medicaid managed care environment is presenting unique risks for fraud, waste, and abuse. That's why it's important for payers to have proven detection and control processes in place - processes that can address and anticipate the program abuse, wasteful spending, and fraud schemes. Join Truven Health experts as they discuss new innovations in fighting fraud waste and abuse in a managed care environment, including predictive modeling, and key algorithms from the industry's largest algorithm database. During this session, presenters will review fraud solutions, schemes, key algorithms, predictive analytics, technical and analytic approaches, and trends seen in the U.S. with a focus on what works to prevent fraud, waste, and abuse in the health care payer world. Truven Health has been helping Medicaid agencies, CMS, analysts and SIU departments in identifying, recovering and preventing fraud, waste and abuse for more than 30 years.