Big data – How to mine data to avoid big problems before DOJ comes knocking

Increasingly, the United States government is focusing on its own data to identify potential health care prosecutions. One need look no further than recent proclamations by U.S. Attorney General Jeff Sessions.

In a recent speech, he noted that – in response to the opioid epidemic afflicting America – the Department of Justice (DOJ) has created a new Opioid Fraud and Abuse Detection Unit. He described this unit as being able to “tell us important information – like who is prescribing the most drugs, who is dispensing the most drugs, and whose patients are dying of overdoses.” It should come to no surprise to most sophisticated healthcare companies that DOJ is mining government data, from the Centers for Medicare and Medicaid Services (CMS), TRICARE, and other federal agencies, to identify possible targets for prosecutions.

The complete article first appeared in Becker's Hospital Review on March 23, 2018.