AGA Fraud ‘26

T103: The Hidden Link: Leveraging Financial Intelligence to Combat Healthcare Fraud (Room Atrium Hall)

22 Sep 26
9:55 AM - 10:45 AM

Tracks: FOS: FINT (Finance-Technical)

Speaker(s): Richard Magill, Intelligence Research Specialist, Financial Crimes Enforcement Network (FinCEN); Mary Vanatta, Senior Advisor for Program Integrity, Centers for Medicare and Medicaid Services

Moderator(s): Stephen Mahmood, Fraud Threat Leader, Deloitte;

Healthcare fraud often hides behind shell entities and layered accounts that claims data can't fully reveal. This panel shows how the Centers for Medicare & Medicaid Services (CMS) claims analytics flag suspicious billing, while financial intelligence traces the money. It also covers how state Medicaid agencies use electronic funds transfer (EFT) data, shared bank accounts, routing numbers and signatories to expose hidden provider ties, detect shell networks and prioritize entities for audit or review.