Professional fraud rings continue to find ways to exploit government programs because the systems, data and processes are managed separately. To prevent this, several states are embracing a statewide approach to fraud.
North Carolina, Michigan, and the Commonwealth of Kentucky are now using an enterprise approach - coupled with SAS analytics to model aberrant behavior - for a pre-payment fraud prevention approach, as opposed to the ineffective “pay and chase” strategies. For example:
- The North Carolina Financial Accountability and Compliance Technology System (NC FACTS) program was launched in 2012. It is intended to develop and implement an enterprise fraud, waste, and improper payments detection program.
- Michigan’s Enterprise Fraud Detection System (EFDS) will initially integrate and analyze data from the Michigan Unemployment Insurance Agency and the state’s Departments of Human Services and Community Health. Additional data sources will be added over time.
- In December, The Commonwealth of Kentucky licensed a SAS-hosted enterprise fraud solution to address fraud, waste and abuse around eligibility and claims for Medicaid; Supplemental Nutrition Assistance Program (SNAP); and Temporary Assistance for Needy Families (TANF). It is anticipated that additional government programs will be added in the future.
Want to know more? Be sure to read the white paper: An Enterprise Approach to Fraud Detection and Prevention in Government Programs.