To find fraud, follow the money,” says Dr. Jacob Kuriyan, president of Physmark, Inc. and Care Maps, Inc.
In his presentation at the 2022 EJ Ourso College of Business Fraud and Forensic Accounting Conference, Louisiana State University, Baton Rouge, the scientist will disclose the results of a survey of myriad health care data.
“We found fraud at the top of the food chain – in multi-billion dollar transactions between the government and health insurance companies,” Kuriyan says.
After decades of coding software for healthcare organizations, Kuriyan has developed highly complex forensic accounting tools capable of revealing the true costs of medical services.
“Insurance companies routinely overcharge the government for their Medicare health insurance program,” Kuriyan says and provides proof: After analyzing the data, according to the State Legislative Finance Committee, New Mexico has recovered $660 million in “intentional overpayments” during the period of 2014. – 2017.
Accurate auditing is vital. Due to rising health care costs, millions of people in the United States will have access to very limited health care – or none at all. Therefore, Kuriyan offers a way out:
“If we have the opportunity to look at the data with our CareMaps program, the US government will likely be able to recover over $100 billion from insurance companies.