FraudCast
Welcome to the Pondera FraudCast, where we post information on fraud trends, lessons learned from client engagements, and observations from our investigators in the field. We hope you’ll check back often to stay current with our efforts to combat fraud, waste, and abuse in large government programs.
Trends in Physician Exclusion: Characteristics for Consideration to Complement Analyses
By Amy K., Training & Development Manager
January 16, 2019What is predictive profiling? How does predictive profiling help the healthcare industry? How do statistics and identifying traits inform decision-making about healthcare providers? Predictive profiling is often criticized for its use by law enforcement as potentially being biased or perpetuating inequality. However, I have spent the last 24 years investigating financial fraud with data analytics. […]
Read more
Elder Financial Fraud
By Mark L., Director of Intelligence
January 9, 2019For most of us, receiving a phone call or email advising we had just won the lottery likely would be followed by a quick hang-up, deletion, or not-too-subtle reply of “bug off”. The attempted scam would be obvious, and we would move on with our daily lives without any further thought of missing out on […]
Read more
Phishing for Fishing Gear
By Caryn O., Director of Marketing
January 2, 2019Whew! The holidays are over, and I wore out my Amazon.com account to find the perfect gifts. It seemed I received a shipment update email every day. In order to keep track of the dozen gifts I had ordered, I quickly glanced at each email to see if any action was required. A week before […]
Read more
The Health Impact of Fraud
By David D., Account Executive
December 21, 2018As the PI Director at an MCO and as the VP at the South-Central US ZPIC, I saw the impact that fraud has on the bottom line every day. Healthcare fraud costs the government and private insurance billions of dollars annually. The system is built on trust, as consumers/patients, we trust that the physician, hospital, […]
Read more
Analytics are more than Numbers and Stats – It’s About People by Tammy Marple, VP – Special Investigations Unit
by Tammy M., Vice President SIU
August 7, 2018During my time as a fraud analyst, I realized that my work was so much more than just numbers and statistics. I worked in State Government for many years and a few years ago, my manager asked me to conduct a study on Opioids. I lived that assignment for 18 months. After the Opioid study […]
Read more
Cigarette Fraud
By Jon Coss, CEO
May 14, 2018Last week we wrote about charges being brought against a group of alleged fraudsters in California that were trucking thousands of cans and bottles into California to collect the state’s recycling refunds. This week, just so no one feels left out, we’re bringing you a story from the East Coast that deals with cigarette fraud. […]
Read more
How to Steal $80 million Five Cents at a Time
By Jon Coss, CEO
May 10, 2018Last week, in the realm of “are there any government programs fraudsters won’t steal from”, California officials announced charges against five people who were ripping off the state’s recycling program. Four defendants are accused of accepting recyclable cans from other states, faking the paperwork, and then billing the state for refunds on the 5- or […]
Read more
How Fraudsters Stole Money from Venmo Users
By Jon Coss, CEO
April 10, 2018In yet another example of the creativity of fraudsters exploiting security flaws in commonly used services, the Federal Trade Commission recently announced a settlement with Venmo, the popular money exchange service. The charges, filed in 2016, include some surprisingly basic security flaws in Venmo, which boasts of “bank-grade security”. One major problem was found in […]
Read more
City of Atlanta Victimized by Ransomware
By Jon Coss, CEO
April 4, 2018Imagine walking in to work and being handed a printed out note instructing you to not turn on your computer because of a ransomware attack. Then imagine that you are instructed to monitor your personal bank accounts because your employer is unsure exactly what information has been compromised. For city employees in Atlanta, they don’t […]
Read more
Ambulette Fraud
By Jon Coss, CEO
March 28, 2018“Ambulette” is a term to describe the vans and cars that transport Medicaid patients to non-emergency appointments. Despite the presence of ambulettes, millions of Americans continue to miss medical appointments each year because of transportation problems. One possible answer to this problem? Rideshare companies like Uber and Lyft who sign agreements with hospitals and medical […]
Read moreRequest a Demo
Our industry experts are happy to provide an in-person or web conference overview that is customized to your organization and your needs.
Request Demo