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The Fraud Prevention Institute (FPI) is a not-for-profit research and educational organization committed to combating the ever increasing incursion of fraudulent billers within the health care system.
The vast majority of this nefarious activity concentrates with Medicare and Medicaid. The Federal Office of Management and Budget along with the Inspector General for Health and Human Services now acknowledge that fraud diverts over 14-percent of all funding within Medicare.
Though an authoritative review within Medicaid has not been performed, based upon prior and current analysis activity, FPI estimates that between 25 and 30-percent of all funding is diverted to fraud.
FPI studies patterns of criminal activity along with upgrades used by fraudulent billers to steal money from these programs. FPI then develops software filters to spot fraudulent billing before a claim is paid. FPI then works with federal, state and local law enforcement to use the data developed to target criminals for further investigation and prosecution.
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