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Social media posts can be used to detect healthcare fraud

June 21, 2017

In George Orwell’s novel Nineteen Eighty-Four, citizens of Oceania, a totalitarian state, are under surveillance at all times and constantly reminded that Big Brother is watching them.

Today, with the advancement of digital technologies – from cameras on the street and in stores, to cookies gathered from the Internet – most of us are being watched in one way or another.

For those in law enforcement, digital technology has become an increasingly important tool in the war on crime. A 2014 report by LexisNexis on social media use in law enforcement found 51 percent of those surveyed listen to or monitor social media activity for potential criminal activity and two-thirds of those surveyed found social media to be a valuable tool in anticipating crimes.

While many might think such criminal activity being monitored would be limited to identifying drug dealers, gang members, thieves and sex offenders, you might be surprised to learn that those in the healthcare arena are just as likely to be targeted and monitored.

By analyzing data from social networks, fraud detection systems can root out suspicious activity by connecting the relationship dots. For example, many times healthcare fraud is conducted by teams with a provider at the top recruiting “patients” (often friends, relatives and associates) to allow their medical records to be used to submit false claims. Investigators can use social networks, i.e. Facebook, Instagram, Twitter, etc. to link these people and put together a case.

In a number of instances, criminals have been caught and arrested for posting their own criminal activity on social media. Last September, a couple was arrested and charged with bank robbery after posting pictures of themselves on social media with stashes of cash.

Although there are some who are foolish enough to post their criminal activities on social media, it doesn’t have to be that blatant. For example, someone recruited by a healthcare provider to commit healthcare fraud might post something on their social media about how they made $100 just by allowing their medical records to be used. A simple post like that might be enough to launch an investigation – and as previously noted – get investigators to begin connecting the relationship dots.

Investigators can even infiltrate these social media networks using false names and identifications. They might pose as someone who wants to get in on the action, which in turn can help lead to the provider who was recruiting “patients” to assist in the fraudulent activity. Even if the police don’t spot such illegal activity, someone within that social network might see such a post and contact the authorities.

While we may not yet live in an Orwellian society, many of our activities are being monitored and the continued advancement of digital technologies is making it easier for fraud investigators to catch up with criminals.

The Health Law Offices of Anthony C. Vitale has been defending those charged with healthcare fraud for more than 25 years. Our team of highly skilled attorneys and consultants is here to help you before you become the focus of an investigation and will aggressively defend you should you become the target of one.

Source: www.vitalehealthlaw.com

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From → Scoop.it

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