Sandata Leverages EVV Data to Tackle Fraud, Waste, and Abuse

Results to be Shared at Annual Medicaid Innovations Forum

January 11, 2023 – Hicksville, NYSandata’s analytics are being utilized to address Fraud, Waste, and Abuse (FWA) in State Medicaid programs. Working with EVV data and artificial intelligence models, Sandata has partnered with the DC Department of Healthcare Finance, to identify suspected cases of FWA.

Kirit Pandit, Sandata’s VP of Data Analytics, and Kevin O’Donnell, Director, Division of Program Integrity, DC Department of Healthcare Finance, will be co-presenting the results of these efforts at the 14th Annual Medicaid Innovations Forum on February 6-7, 2023, at the Gaylord Palms Resort and Convention Center in Orlando, Florida.

This presentation will include examples of data patterns that can flag potential FWA cases, help attendees understand what data elements are required for EVV, and how leveraging that data can then be used to proactively address cases of FWA.

Sandata has developed FWA analytics dashboards to mine EVV data and train models to uncover suspected cases in near real-time, including data that reveals:

(a) caregivers who are with multiple members in different locations at the same time, often representing multiple agencies
(b) caregivers who check-in and check-out from a remote location
(c) members who have multiple caregivers at the same time for the same service
(d) caregivers who consistently exceed their authorized time,
(e) caregivers who have a pattern of manually adjusting their start and end times

“We are very excited to share the compelling results of this partnership at the Medicaid Innovations Forum,” said Pandit. “We’re looking forward to working with other organizations and clients to expand this program, ensuring there is proactive visibility into Fraud, Waste and Abuse in the Medicaid market”.

The presentation will take place during the first day of the forum, Monday, February 6, 2023 at 4:40pm ET. To register, visit: https://www.medicaidinnovations.com/register.php. If you would like more information on how your organization can work with Sandata, please reach out to us at infosales@sandata.com.

About Sandata 

Sandata Technologies, LLC, is a leading U.S. provider of technology to improve ease of collaboration between Medicaid payers and providers to deliver care. Sandata’s transformative technologies and extensive industry experience creates benefit for clients through embedded expertise to support and problem-solve. As a national EVV leader, Sandata’s suite of solutions offers its 15,000-plus agencies, 21 state Medicaid departments, and 50-plus managed care organizations the tools and capabilities to advance quality of care and improve

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