SAS is supportive of the Agency's proposals to permit data mining activities to uncover fraud before payment. Our concern is that by limiting the ability to search only claims data, investigators may not be able to fully understand the linkages of behaviors and people that should be further investigated. Thus we believe things like call center records and hotline fraud data should also be included. As such, we would recommend a slight modification in the definition of data mining to read as follows: "Data mining is defined as the practice of electronically sorting Medicaid claims and other supporting documentation through statistical models and intelligent technologies to uncover patterns and relationships contained within such information to identify aberrant utliziation and billing practices that are potentially fraudulent."
Comment on FR Doc # 2011-06012
This is comment on Proposed Rule
State Medicaid Fraud Control Units; Data Mining
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