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Discussions about fraud, waste, and abuse in government programs are buzzing across America. As Amanda D’Amico , TrackLight’s Chief Product Officer, points out, the key question is: what’s next? How do we address systemic issues rather than just stopping at quick wins? “It is important to do that initial scan—that initial assessment of where we have the most waste or abusive government spending happening,” Amanda explains. “Where is the most fraud happening? Rooting out what

Fraud prevention in government programs isn’t just a job—it’s a balancing act. Amanda D’Amico, TrackLight’s Chief Product Officer, has spent her career navigating the complexities of programs that provide critical support to individuals and families in need. She understands the challenges firsthand:  “How do we get benefits to individuals in need as quickly as possible, as efficiently as possible, while protecting precious government resources and ensuring those benefits go t

Artificial Intelligence (AI) is a powerful tool. But in the world of fraud prevention, it’s only as effective as the expertise guiding it. I’ve spent over two decades in fraud detection, and one thing has always been clear: technology alone cannot replace the people behind vital government programs. Instead, it should act as a force multiplier , amplifying the capabilities of fraud fighters like you and me. Here’s the reality: while we’re debating how to use AI ethically, the

Fraud doesn’t always arrive with a loud crash—it sneaks in quietly, like a late-night phone call in an empty office. For Mike, this truth hit home early in his career when a simple ringing phone uncovered a payroll fraud scheme and set the stage for his life’s work in uncovering fraud. Here’s how Mike’s story unfolded—and the lessons it offers for anyone working to create fraud-resistant systems in today’s digital age. Red Flags and Ringing Phones In the early 1990s, Mike was

Fraud is a rapidly growing threat in today's digital world. In 2023, consumer fraud losses hit a record $10 billion in the US alone, jumping 14% from 2022 (FTC). Globally, fraud losses have reached an estimated $5.4 trillion, with financial services firms seeing nearly 10% increases in fraud costs (University of Portsmouth, fraud.com ). With these rising threats, everyone needs to be aware of these essential fraud prevention tips. In honor of Fraud Awareness Week, I'm sharing

Fraud in federal grant programs like the Small Business Innovation Research (SBIR) Program often goes unnoticed until it’s too late. However, with the right tools and proactive measures, these schemes can be identified and stopped early. This post is a reflection a SBIR fraud case I worked in the past that highlights the importance of data-driven oversight.   The Case: A Tale of Dual Identities One company claimed to operate out of a residential home in Idaho while using a ma

Introduction The U.S. Department of Housing and Urban Development (HUD) plays a critical role in providing affordable housing and urban development programs across the country. In addition, HUD must respond to housing crises in a timely fashion, while ensuring applicants are compliant and eligible with program regulations. Today’s systems can  make it difficult to balance the speed of the screening process with the need to deliver the benefits.  Artificial intelligence (AI) h

Medicare fraud is a pervasive issue that drains billions of dollars from the healthcare system each year. While much attention has been focused on fraudulent activities by healthcare providers, private insurers also play a significant role in this deceptive game, especially within the Medicare Advantage program. For government agencies and oversight professionals, understanding these schemes is essential to safeguarding the integrity of Medicare. Inflating Diagnoses One of th

One of the most interesting parts of anti-fraud research is using applied math and machine learning techniques for analysis and novel feature engineering development. In this space we can use statistics to build on previously conducted research in social science areas such as behavioral psychology and linguistics. This helps us better understand how fraud practically manifests in the data. One recent analysis highlights how this can be used to leverage data and understand wha

Medicare fraud is a critical issue affecting the healthcare system, with individual healthcare providers playing a significant role, sometimes unknowingly. For government agencies and oversight professionals, understanding the various ways in which providers can be associated with Medicare fraud is essential for implementing effective prevention and detection strategies. Billing for Services Not Rendered One common fraudulent practice involves submitting claims for procedures