By skyforbes 
Data Mining in the Medicare/Medicaid system was made legal in 2013. How do authorities use this data to catch bad actors?
In the United States, Medicare is the national health insurance plan made primarily available to older citizens over the age of 65. This program is expensive, partly due to America’s aging population and sky-rocketing healthcare costs. It is financed through general government revenues (43%), payroll taxes (36%), and beneficiary premiums (15%). There are three main parts to the Medicare program:
- Medicare Part A : covers mostly inpatient hospital and hospice care.
- Medicare Part B: covers mostly hospital outpatient services, and prescriptions administered by a healthcare worker while in the hospital.
- Medicare Part C: (aka – Medicare Advantage) are private plans subsidized by the government that need to offer the same coverage as Part A and Part B and are sometimes administered by private health insurance companies.
For this project, we also look into an aspect of the Medicare program, usually billed under Medicare Part B, knows as Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).