Identity Resolution Daily

By the Infoglide Team

OCDQ Blog: The Data-Decision Symphony

“Data is now everywhere.  Data is no longer just in the structured rows of our relational databases and spreadsheets.  Data is also in the unstructured streams of our Facebook and Twitter status updates, as well as our blog posts, our photos, and our videos. The challenge is can we somehow manage to listen for business insights among the endless cacophony of chaotic data volumes, and use those insights to enable better business decisions and deliver optimal business performance.”

SecurityInfoWatch.com: Welcome to the melting pot

“A Fusion Center is a terrorism prevention and response center program that began as a joint project between the DHS and the U.S. Department of Justice’s Office of Justice Program. It is designed to gather information from government and the private sectors to aid in safety and security. The Fusion Centers share information at the federal level between the CIA, FBI, DoJ, U.S. Military and state and local level governments, as well as Emergency Operations Centers in the event of a disaster. State and local police departments provide both space and resources for the majority of Fusion Centers. The analysts working there can be drawn from DHS, local police, or the private sector as in the case of Dallas.”

South Florida Business Journal: Clinic operator convicted in $2.3M fraud

“According to evidence presented during the two-week trial in Michigan, between about November 2006 and March 2007, the defendants submitted about $2.3 million in claims to Medicare for injection therapy services that were never provided and were not medically necessary. Medicare paid about $1.7 million.”

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[Post from Infoglide] Surface Web, Dark Web, and Social Media

“A recent article in Bank Systems & Technology  says that financial services institutions are discovering increasingly sophisticated attempts to defraud their customers – more sophisticated in how they gather information and employ it in their criminal schemes. ‘As fraudsters increasingly seek to exploit weaknesses in consumers’ defenses through social engineering schemes rather than hack vulnerabilities in banks’ security systems, the need for enterprisewide solutions to detect fraud across channels is greater than ever.’”

IT-Director.com: An Intelligent Match

“Buying rather than building speeds up the process of filling gaps in (or simply improving) functionality, and so is a logical step, and Experian itself has plenty of acquisition experience (including of course QAS itself). It opens up the intriguing possibility that Experian QAS may be looking in the future to spread its wings beyond its historically tight market of contact data management. If so then this may not be the last acquisition that it makes.”

AllBusiness: TSA “Secure Flight” Requirements

“Effective November 1, 2010, if you do not accurately provide the TSA with your full legal name as it appears on your government issued identification within 72 hours of a flight, your reservation could be canceled, at will, by the Transportation Security Administration (TSA). Why are they doing this?  To enhance the security of commercial air travel, the TSA has developed Secure Flight, a program that compares airline passenger information against U.S. government watch lists.”

InformationWeek: Top 10 Cloud Computing Complaints

“‘You need the ability to migrate data from one cloud service provider to another, and there are cloud interoperability scenarios that need to be addressed as well,’ notes Matt Edwards, director of the cloud services initiative at TM Forum, a communications industry association. ‘There are multiple things that need to be addressed to avoid vendor lock-in and to remove the barriers for the adoption of cloud services.’”

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By Mike Betron, Infoglide Software Director of Marketing

A recent article in Bank Systems & Technology says that financial services institutions are discovering increasingly sophisticated attempts to defraud their customers – more sophisticated in how they gather information and employ it in their criminal schemes. “As fraudsters increasingly seek to exploit weaknesses in consumers’ defenses through social engineering schemes rather than hack vulnerabilities in banks’ security systems, the need for enterprisewide solutions to detect fraud across channels is greater than ever.”

The sources of information about individual consumers are rapidly growing and increasingly accessible. Most of us concerned about our personal information think first about that portion of the World Wide Web that is indexable by conventional search engines, sometimes called the “surface web.” That information is more easily monitored and managed than social media sites (e.g. Facebook) and other dark web sources such as local, state, and government databases.

What is needed is a comprehensive picture of our personal online reputation, but it’s not a simple task. It requires the ability to tie together diverse data from a multitude of sources in a variety of formats. Using similarity searching, advanced filtering, and sophisticated scoring, federated searching across disparate data sources can produce a unified view of an individual’s “identity” for ongoing monitoring. Ideally, that unified identity can be refreshed using automated rather than manual processes.

Identity resolution offers the ideal core technology for any solution designed to present a unified picture of personal identity across surface web, dark web, and social media sources. Since identity resolution engines are designed to incorporate new data sources without requiring system rewrites, they offer the best hope for deployment of extensible systems for online identity management.

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By the Infoglide Team

Fraud Prevention: Medicare and Medicaid Fraud: US Healthcare Reform

“Earlier this year, a jury found Pfizer owed Wisconsin $9 million for violating the state Medicaid fraud law more than 1.4 million times by purposely overcharging the state for prescription drugs. The company faces potential fines from $140 million to $21 billion.”

Security Debrief: What is a Law Enforcement Fusion Center?

“Fusion centers that are doing strategic analysis are best positioned to prevent criminal acts. Trained intelligence analysts in these centers look at a local tip or Suspicious Activity Report (SAR) and then use advanced search tools across many databases simultaneously for indications that the tip could be part of a much bigger ‘iceberg’ hiding below the surface.”

ZDNet: Yankee Group: Infrastructure as a Service now a bona fide cloud strategy

“The survey of 400 enterprises finds ‘24 percent of large enterprises with cloud experience’ are already using IaaS, and an additional 37 percent expect to adopt IaaS during the next 24 months. ‘While adoption is still much slower than that of SaaS solutions, the market is gaining traction,’ says Yankee.”

Detroit Free Press: Tiny name differences on tickets not a worry

“Under its new ‘Secure Flight‘ process, the government compares airline passenger names, gender and birth dates with data on a terror watch list. However, a reservation or boarding pass that uses a middle initial instead of a full middle name, misses a hyphen, contains a tiny typo or leaves off the ‘Jr.’ designation should not cause a problem, according to the Transportation Security Administration.”

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[Post from Infoglide] Best Practices Just Got Better

“On the heels of the very successful Association of Certified Fraud Examiners (ACFE) conference last month comes an industry event which represents investigators of financial crimes and fraud.  The International Association of Financial Crimes Investigators (IAFCI) meets in Washington, DC next week  with an agenda that is chock full of sessions involving discussions of best practices for solving and preventing financial crimes.”

Insurance & Technology: Analytics Improving Insurers’ Claims Fraud Detection Efforts

“In a recent report, Light noted that the key to successful fraud mitigation with technology is applying a combination of several methods - including the typical red flag approach, predictive modeling, neural networks, profiling, claims databases and identity matching - to ‘maximize the identification of true positive fraudulent claims and of true negative fraudulent claims.’”

Paul Davis on Crime: Connecting the Dots at the Local Level: Centers Make Homeland Security a State, City, and Local Affair

“Robert Riegle from the Department of Homeland Security describes fusion centers as force multipliers. ‘They leverage financial resources and the expertise of numerous public safety partners to increase information awareness and help our law enforcement agencies more effectively protect our communities.’”

The Blog: Judy Schurke, Director, Department of Labor & Industries

“L&I works extensively with state and federal law enforcement, and other regulatory agencies to detect and prosecute individuals committing workers’ comp fraud, contractors failing to register with the state, and businesses that wrongly classify workers to cheat on insurance premiums. Some investigations lead to criminal prosecution. People tend to think fraud only involves workers cheating the workers’ comp system. But in reality, millions of dollars are lost when employers, medical providers and contractors commit fraud.”

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By the Infoglide Team

All247News.com: Medicare Fraud: Updates on Government’s Efforts to Recover Money Lost to Scam Artists

“Medicare fraud and billing errors costs the government more than $36 billion last year, the Economist noted. The modus operandi involves a “care-provider” billing Medicare for non-existent or unnecessary services. These services and items include: HIV/AIDS medicines and therapy; medical equipment such as wheelchairs to neck and knee braces, as well as home health care, physical and occupational therapy and mental-health services.”

CBCnews: Crime proceeds crackdown looms

“Another method used by organized crime is to pay a 10 per cent premium for winning lottery tickets or to buy jewelry in Canada worth tens of thousands of dollars and sell it in the U.S., achieving money laundering and foreign exchange conversion at the same time.”

San Antonio Express-News: Police ‘fusion center’ on the way for S.A.

“Each center can have an individual purpose, McManus said. The South Texas center will have two branches: one working on homeland security, bolstered by a new San Antonio Police Department Terrorism Criminal Intelligence Division, the other a 24-hour tactical operations center for ‘all crimes and all hazards as they occur in San Antonio and the region.’”

Washington State Wire: Will a ‘September Surprise’ Derail Workers’ Comp Initiative?

“Schurke said a fraud-prevention effort launched in 2005 has increased collections dramatically. Collections due to L&I investigations have increased 40 percent, to $770 million. The department has invested in advanced computer technology that should make it easier to track down employers who are not reporting fully. The systems will make it possible to compare 20 state and federal databases, including the IRS.”

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[Post from Infoglide] The Not So Great Fortune 500 Enterprise

“Of the various types of crime involving fraud, individual cases of people scamming workers’ compensation garner the most publicity. The stories typically read like this: ‘Joe Blow was drawing workers’ comp while working as a personal trainer, and after he was caught on video, he had to pay back $9000 and received a five-year suspended jail sentence.’ While the human interest aspect of these stories, especially those including video of an injured worker involved in heavy physical activity, capture the most public attention, more organized activities impact the U.S. economy much more negatively.”

Cato Unbound: The Sky Isn’t Falling

“But a careful observer can detect the outlines of other intelligence successes based on surveillance in recent events. When David Headley was arrested for allegedly seeking to commit terrorist acts in Denmark, news reports suggested that one of the key factors in his identification was his pattern of travel to the Middle East and his efforts to conceal those trips from the government. Review of his travel both provided the trigger to ask questions and the factual cross-check on the veracity of his answers. Likewise, when Najibullah al-Zasi was arrested, one factor that was publicly disclosed as a ground for suspicion was surveillance of his travel to Pakistan.”

CIO: Healthcare Data Quality: Providing Better Patient Care

“Three things immediately jump to mind. The first is something very basic, but important: being able to identify a patient. Think of how many different ways might a patient’s name appear in a physician’s database. From misspellings to inconsistent middle name initial usage, multiple combinations of a name can lead to confusion. If healthcare providers don’t know who their patients are, how can they provide them with quality service?”

GovMonitor: Washington Cracks Down On Workers Compensation Fraud

“‘For every dollar Labor and Industries spends to combat fraud, we’ve seen an eight dollar return,’ Gregoire said. ‘By preventing and punishing fraud, we protect workers and honest businesses from unfair competition. Fraud in the workers’ compensation system hurts our economy – honest businesses are undercut by those that don’t fairly participate in the system and workers pay more than they should when others claim more benefits than they deserve.’”

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By Mike Betron, Infoglide Software Director of Marketing

Of the various types of crime involving fraud, individual cases of people scamming workers’ compensation garner the most publicity. The stories typically read like this: “Joe Blow was drawing workers’ comp while working as a personal trainer, and after he was caught on video, he had to pay back $9000 and received a five-year suspended jail sentence.” While the human interest aspect of these stories, especially those including video of an injured worker involved in heavy physical activity, capture the most public attention, more organized activities impact the U.S. economy much more negatively.

The National Insurance Crime Bureau (NICB) recently released a comparison of reported instances of suspected insurance fraud for the first half of 2010 versus the first half of 2009. An article in the Charleston Post and Courier observed that “while there’s no definitive study to link the economic recession to insurance fraud, certain types of claims are rising as other forms of income, from stock dividends to paychecks, are drying up. And the trend is creating more work for the parties who work together to fight insurance fraud.”

In highlighting the cost of fraud three years ago in IdentityResolutionDaily, we tagged it as a tax on all of us. The Post and Courier article said that “those types of insurance cost more than $85 billion a year, spreading an extra cost of $1,030 per year to the average household.  ‘If insurance fraud was a business, it would be a top Fortune 500 company,” the A.G.’s website states.’”

The bad news is that this “Fortune 500” fraud enterprise is big and growing; the good news is that the more organized it gets, the more detectable it becomes using entity resolution.

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By the Infoglide Team

The Post and Courier: Fighting fraud: Link between bogus insurance claims, recession is murky

“At the national level, the number of potential fraud cases continued to rise throughout the first half of the year. Figures released last week by the Illinois-based National Insurance Crime Bureau show a 14 percent increase in questionable claims of the year in four of the six categories the agency tracks… Nationally, reported incidences of suspected organized insurance fraud cases grew 65 percent to 1,837 cases during the first six months of 2010 compared to the same period in 2008, according to the National Insurance Crime Bureau.”

Center for Investigative Reporting: Maryland to store license-plate scanner data at intel fusion center

“The initiative makes Maryland among the first nationally to establish a statewide network for data generated from license-plate readers. While the devices have not endured regular scrutiny and occasional opposition the way public surveillance cameras have historically, the technology in many respects is more powerful. Privacy advocates warn that plate recognition enables police to document where drivers go – both guilty car thieves and innocent citizens alike – by registering their GPS locations when each license plate is scanned. Police need reasonable suspicion that a crime has been or will be committed for much of the contact officers have with the public, at least in theory. But laws that restrict data gathering by law enforcement don’t always keep up with the 21st century.”

Fidelity.com: HSBC says subject of U.S. money laundering probe

“American authorities are investigating the U.S. division of global banking group HSBC over its compliance with anti-money laundering procedures, according to a regulatory filing… ‘These examinations and inquiries pertain to, among other matters, our global banknotes business and our foreign correspondent banking business, and our compliance with the Bank Secrecy Act, Anti-Money Laundering and Office of Foreign Assets Control requirements,’ the filing said.”

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[Post from Infoglide] Reference Linking Methods - Part 3

“This is the third in a series of four posts that discuss four methods for linking references.  These methods are:

1. Direct matching
2. Transitive linking
3. Linking by association
4. Asserted Linking

In the last post I discussed transitive linking, and why it is essential for producing a unique and deterministic outcome of an ER process.  In this post I will discuss the third method, linking by association.”

BeyeNETWORK: Computed Attributes, Entity Resolution and Connectivity Hierarchies

“There are many types of relationships that are discovered as a by-product of entity resolution, such as households or families. These terms take on different meaning depending on the subject area and the business situation. For example, we can examine parent-child and sibling relationships associated with individuals, we can look at components such as paper clips or screws that are in the same ‘family,’ or we can look at corporate ownership relationships that reflect families of companies. Alternatively, we can look at other types of relationships – individuals belonging to the same health club, components manufactured from the same type of metal, or companies that share the same board members.”

WTVM: Phenix City doctor accused of multi-million dollar Medicare fraud

“In an 80-page  civil complaint, the United States Attorney’s Office claims 51-year-old Doctor Robert Ritchea, a physician, not only allowed an unlicensed medical assistant to inject patients with pain medications, but also improperly billed Medicare for the treatments. The complaint also alleges Ritchea over-billed Medicare by more than $2.2 million in over 4,300 separate claims over a period of four years.”

Liliendahl on Data Quality: Location, Location, Location

“If you know that 123 Main Street in Anytown is a single family house there is a high probability that this is the same real world individual. But if you know that 123 Main Street in Anytown is a building used as a nursing home, a campus or that this entrance has many apartments or other kind of units, then it is not so certain that these records represents the same real world individual (not at least if the name is John Smith). So this example highlights the importance of using external reference data in data matching.”

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