Bass, Berry & Sims attorney Matt Curley provided insight for an article in Law360 Healthcare Authority examining the use of artificial intelligence (AI) to pursue claims of healthcare fraud. Recently, the U.S. Department of Justice (DOJ) announced charges against 324 defendants in connection with alleged healthcare fraud schemes. According to the DOJ, this latest takedown utilized “advanced digital tools,” such as AI, that allowed the government to pursue such a wide range of violations both geographically and among various industry sectors.
“The announced DOJ healthcare fraud takedown is similar in many respects to the results announced in prior years,” said Matt. “The results in terms of the number of defendants charged across the country and the nature of the alleged fraud schemes continue to reflect the DOJ’s robust efforts in pursuing alleged healthcare fraud.”
While the DOJ has long used data analytics to detect and investigate potential healthcare fraud, Matt said he expects the continued rollout of AI in enforcement to be rapid.
“It certainly would seem that artificial intelligence will enhance the effectiveness of those tools and perhaps assist the DOJ in spotting fraud earlier with respect to particular schemes and help the DOJ identify other areas of vulnerability that may not have been a traditional focus of their enforcement efforts,” Matt added.
The full article, “The AI Red Flags In DOJ Fraud Investigations,” was published by Law360 Healthcare Authority on July 8 and is available online.