Rockland County Pilots Ibm Software System To Detect Medicaid Fraud And Abuse

Senator Thomas P. Morahan (R-C, New City), joined Rockland County Executive C. Scott Vanderhoef to announce Rockland County’s participation in a program developed by IBM, in cooperation with the New York State Association of Counties (NYSAC), designed to detect Medicaid fraud through the use of advanced mathematical algorithms developed by IBM experts.

Verify NY, a data-mining computer software system, was showcased at a ceremony in New City. The IBM fraud and abuse management system tracks health-care providers’ claims, and flags irregular billing practices and procedures that can cost taxpayers billions of dollars in Medicaid fraud, waste and abuse.

"The Verify NY project will provide Rockland County with the the tools it needs to ensure taxpayer dollars are not being wasted on illegal billing practices," said Senator Morahan

IBM, which has successfully used this supercomputer system to help insurance companies eliminate fraudulent insurance claims, will use a secured connection that will enable Rockland County Department of Social Services to upload Medicaid provider data to the supercomputer, where advanced mathematical algorithms will comb through the information for patterns of behavior that are suspicious. Those items would be flagged for futher investigation.

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