SAS Steps up Fight against Fraud, Waste and Abuse across Industries

The quantity and sophistication of fraud, waste and abuse activities in government, banking, insurance and health care is surging, but those organizations are fighting back. Evidenced by a 370 percent jump in its total anti-fraud software revenue from 2010, SAS, the leader in business analytics software and services, is the weapon of choice to combat such challenges as money laundering, organized fraud rings, and benefits, claims and card fraud.

"Fraud impacts everything from benefits fraud in Medicare/Medicaid, disability, food stamps and Small Business Administration loans to Internet and credit-card fraud and identity theft," said Chris Swecker, former FBI Assistant Director, Attorney and CEO of Chris Swecker Enterprises. "Traditional organized crime has been supplanted by nimble, tech-savvy, global networks perpetrating financial crimes and Internet scams of every description. Sophisticated fraud analytics are essential to hunt down these malignant social networks of cybercriminals."

In Government

The US Office of Management and Budget reports more than $ 125 billion lost to improper payments in 2010 alone. SAS technologies help fight fraud, waste and improper payments. The SASFraud Framework for Government helps federal, state and local government in many areas -- from detecting collusive patterns in entitlement programs to purchase-card fraud, bid-rigging and terrorist financing.

SAS Analytics is helping to detect fraud and recover money at every level of government. In the last month, the US Internal Revenue Service and US Citizenship and Immigration Services chose the SAS Fraud Framework for Government to fight fraud in programs.

Armed with an innovative statewide detection system, the Louisiana Workforce Commission (LWC) has collected $ 1.2 million of improperly avoided unemployment insurance taxes, plus penalty and interest. A fraud project in Los Angeles County achieved 85 percent accuracy in detecting collusive fraud rings, and projects returns of up to $ 30 million annually.

LWC analyzes wage and tax filings, unemployment insurance and workers' compensation claims, and new-hire listings to identify fraud. SAS searches the data for anomalies that indicate fraud, applying predictive modeling to historical information to identify suspicious behaviors similar to previous patterns. LWC employs SAS Social Network Analysis to uncover linkages that suggest collusion and organized fraud.

"Our statewide detection system is the first of its kind in the country. With technology replacing previously manual data-mining and analysis, we can better stop fraudsters from shortchanging the state," said Curt Eysink, LWC Executive Director.

In Financial Services

Chartis Research estimates that financial crime IT spending will grow to $ 4.3 billion by 2013. Increasingly, banks and insurers must outsmart fraudsters -- technology is key to detecting, preventing and managing fraud.

SAS fraud solutions revenue in financial services is up 147 percent from last year. Recently, Chartis Research named SAS a leader in Financial Crime Risk Management 2011.

SAS Enterprise Financial Crimes for Banking provides a technology infrastructure for preventing, detecting and managing financial crimes across lines of business within today's banks, including anti-money laundering, card fraud, organized fraud rings, and ACH/peer-to-peer and wire fraud. Banking customers using SAS to combat fraud include Commonwealth Bank of Australia, HSBC and Viseca Card Services.

Property and casualty insurance has also seen an increase in fraud claims. For the first half of 2011, the National Insurance Crime Bureau reports a 4.5 percent rise in questionable claims over 2010. With triple-digit growth in sales, SAS Fraud Framework for Insurance -- for preventing, detecting and managing claims fraud across the various lines of business within today's insurers -- is the fraud weapon of choice with top insurers such as CNA and Hyundai Marine & Fire Insurance.

Health Care

Health care fraud, waste and abuse is about 100 times bigger than fraud in financial services, yet the industry spends only one-tenth as much to battle fraud.

The problem is estimated in health care at up to $ 800 billion annually. Professional fraud involving identity theft and collusion is becoming more prevalent in health care, as organized crime and schemes cross state and country borders to infect the health care industry nationwide. SAS Fraud Framework for Health Care employs multiple analytical methods to spot multiparty fraud schemes. SAS uses a broad array of data -- including unstructured text in electronic medical records, claim processor and nurse notes, and call center logs -- to identify fraud. Two leading Blue Cross Blue Shield companies, and government Medicare/Medicaid agencies, use SAS Fraud Framework for Health Care to stay ahead of fraudsters.

Today's announcement came at The Premier Business Leadership Series event in Orlando, FL, a thought leadership conference presented by SAS that brings together more than 600 senior-level attendees from the public and private sectors to share ideas on critical business issues.