Briefs

San Jose Mercury News, CA (Nov 23)

For Medicare, signs of fraud difficult to spot

...

"There are system checks that you can use to discern patterns, but you would only look at individual claims if you have some reason," said H. Stephen Deering, deputy regional administrator for the Centers for Medicare & Medicaid Services, the federal agency that runs Medicare.

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Government fraud-fighters use sophisticated "data-mining" software to search for suspicious billing patterns, such as an unusually high volume of charges for a doctor or patient, or frequent repetitions of procedures.

See http://www.bayarea.com/mld/mercurynews/news/7331706.htm