Category Archive: Medicaid


Medical Record Healthcare

The Health Impact of Fraud

By David D., Account Executive

December 21, 2018

As the PI Director at an MCO and as the VP at the South-Central US ZPIC, I saw the impact…

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Learning analytics identify human technology

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, 2018

During my time as a fraud analyst, I realized that my work was so much more than just numbers and…

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A New Way to Rip Off the Taxpayer

A New Way to Rip Off the Taxpayer

By Jon Coss, CEO

February 23, 2018

I often mention how “impressed” I am by the ingenuity of fraudsters and their ability to find new and creative…

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$1.5 Million to Clip Toenails?

$1.5 Million to Clip Toenails?

By Jon Coss, CEO

September 9, 2017

While I don’t think healthcare fraud is a particularly humorous subject, a recent case in Florida does lead to a…

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Does the Mylan EpiPen Settlement Send the Wrong Message to Fraudsters?

Does the Mylan EpiPen Settlement Send the Wrong Message to Fraudsters?

By Jon Coss, CEO

August 23, 2017

The United States government and several states recently announced that they had settled a $465 million lawsuit against Mylan Inc.,…

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37 States Targeting Elder Abuse

37 States Targeting Elder Abuse

By Jon Coss, CEO

June 27, 2017

Regular readers of our blog know that Pondera has strong feelings about the need to protect the elderly from abuses…

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New Data on Problematic Government Programs

New Data on Problematic Government Programs

By Jon Coss, CEO

May 3, 2017

One of my favorite websites, paymentaccuracy.gov, has received a number of updates which may provide some insight into the current…

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Disturbing Reports of Nursing Home Abuse

Disturbing Reports of Nursing Home Abuse

By Jon Coss, CEO

April 24, 2017

Last month CNN published a horrifying report on sexual abuse in America’s nursing homes and assisted living facilities. The report…

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Changes to Government Healthcare

Changes to Government Healthcare

By Jon Coss, CEO

November 16, 2016

As a company, Pondera is closely following the comments coming from the incoming administration about how they are approaching government…

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Provider Screening and Program Integrity in Medicaid Managed Care

Provider Screening and Program Integrity in Medicaid Managed Care

By Jon Coss, CEO

June 13, 2016

Medicaid expenditures have nearly doubled over the last decade [1] and states have increasingly looked to a capitated reimbursement model…

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