The AI dug through public Medicare data and flagged billing patterns that look like fraud
A small research outfit pointed the AI at the public 2024 Medicare provider files. It flagged one wound dressing code whose national billing jumped from about $23 million a year to $650 million in 2024, with one Florida supplier taking 62 percent of it, and a pattern of hundreds of family doctors each ordering ostomy supplies for about 175 patients across 40 states while only 15 colorectal surgeons appear in the same data. Some flagged companies have already been caught; others with the same shape are still billing, per the July 2026 enrolment file.
How it works
- Load the public provider files
- The AI hunts for billing patterns that break normal shapes
- Check flagged suppliers against known caught cases
- Compare with the current enrolment file
- Publish the findings with a note to report suspects to the HHS inspector general
Why it’s worth knowing
The check that gives the findings weight: several of the patterns the AI flagged belong to companies that had already been caught.
Where it’s from
Summarized from a public post on reddit.com. See the original ↗