According to the Center for Disease Control and Prevention, 44 people die every day in America from prescription opioid overdoses. In fact, prescription drugs account for 51% of drug overdose deaths. The costs, in hard dollars, for prescription opioid abuse amount to tens of billions of dollars annually in lost productivity, healthcare, and law enforcement activities. Our state Medicaid programs, while delivering vital services to citizens, unfortunately contribute to the drug diversion problem as bad actors abuse the system to obtain and traffic in drugs.
Pondera's System, built "by investigators, for investigators", offers an extremely powerful, yet easy-to-use system to identify and combat Drug Diversion activities. Our integrated system spans detection, investigation, and enforcement.
Detect Drug Diversion:
Fraud Detection as a Service (FDaaS): Core detection system that includes over 45 Alerts, Prediction Models, and Geospatial Analysis Maps designed specifically for detecting Drug Diversion activities. Searches for issues such as identity theft, fictitious providers, prescription spikes and peer comparisons, unusual travel patterns, drug trafficking, and doctor shopping activities.
Investigate Drug Diversion:
SuperSearch: Search the FDaaS database and integrated public records databases for information on suspects, associates, affiliates, and more. Hyperlink to provider, pharmacy, and beneficiary profiles for more information such as fraud indicators, alert history, geospatial maps, and Google Street View of locations.
Link Analysis: Visually explore associations and network linkages between and among providers, pharmacies, and suspects. Use pre-built templates for issues such as corporate associations, clusters of suspects, and shared beneficiaries. Save and share maps with fellow analysts and investigators.
Social Media Analyzer: Search for illegal drug sales on commonly used sites. Discover connections, associations, and investigative data through analysis of social network sites, blogs, and other on-line services. Save newly discovered links to your link analysis charts or open cases.
Enforce Drug Diversion:
Case Tracker: Create, manage, collaborate, and report on cases generated by Pondera or through tips or other automated systems. Add notes, documents, and images to your cases.
Intel Reports: Request in-depth investigative reports from Pondera's Special Investigation Unit (SIU), staffed by certified fraud examiners, former MFCU officials with drug diversion expertise, and former law enforcement agents. Reports include behavioral, link, and social network analysis.
Executive Dashboard: Easily review the results of your detection and enforcement activities via a graphical management reporting system. Analyze your program's most frequent Alerts and trends over time.
Pondera's entire suite of tools is fully integrated, passing data and leads between the detection, investigation, and enforcement modules. Your analysts and investigators access the system through a secure Internet Browser. Additional advantages of Pondera include:
- Rapid Deployments: Go live in as few as 120 days
- Cloud Infrastructure: No need to buy hardware or software
- Machine Learning: Identify emerging fraud trends with constantly improving algorithms
- Integrated Third Party Data: Validate identities, incarceration status, addresses, and more with pre-tested consumer and business databases