Medicaid
4 articles
What 227 Million Rows of Medicaid Data Can and Can't Tell Us
HHS published the largest Medicaid dataset in history. Here's what it contains, what's missing, and why the gap matters for fraud screening.
The Label That Isn't: Why "Excluded" Doesn't Mean "Fraudulent"
40% of LEIE exclusions are license revocations, not fraud. Why the federal exclusion list is a contaminated label for detection.
What Billing Patterns Actually Look Like
Excluded providers have lower billing than non-excluded ones. Label contamination, the autism false-positive problem, and proxy variable bias.
Can a Classifier Find What Investigators Miss?
Logistic regression matches complex ML on honest validation. Model complexity adds noise, not signal.