To help control this problem, some states are taking aggressive steps. The only constant about health care fraud is that it's always changing.
Perpetrators devise new schemes or tweak old schemes every day.
The difficulty lies in developing a system that can continually identify the changing scenarios. By recognizing relationships between providers and beneficiaries, the system can review every transaction and identify inappropriate behaviors to uncover potential abuse. Cases with the best possibility for resolution or largest possibility for recovery can be identified. Instead of having to wait a month for a report, they can access the system and prepare ad hoc reports in a matter of hours. The system also has been commended for its responsiveness, speed and user-friendliness.