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Healthcare Fraud Machine Learning

Rivkin Radler LLP

Expert Witness Report in FCA Case Afflicted with AI Hallucinations

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The epidemic of out-of-control generative artificial intelligence in litigation filings has metastasized to a False Claims Act (FCA) lawsuit against a group of Utah anesthesiologists. On July 25, Mountain West Anesthesia, LLC...more

Health Care Compliance Association (HCCA)

AI and the False Claims Act

There’s always a “but” when it comes to AI. It has great potential, but there’s always the risk of bad things happening. In the case of the False Claims Act and healthcare, that’s very much the case. In a recent article for...more

Phelps Dunbar

Medicare’s New AI Payment Review Model: What Providers Need to Know

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CMS announced the rollout of the WISeR (Wasteful and Inappropriate Service Reduction) model in June. It aims to use technologies like artificial intelligence (AI) to “ensure timely and appropriate Medicare payment for select...more

Benesch

CMS Launches WISeR Model: A Technology-Enabled Effort to Reduce Wasteful Medicare Spending

Benesch on

On June 27, 2025, the Centers for Medicare & Medicaid Services (“CMS”), through its Innovation Center (“CMMI”), released the Request for Applications (“RFA”) for a new payment and service delivery initiative: the Wasteful and...more

Ankura

Forensic Analytics in Pharmaceutical Fraud Investigations: Lessons from Recent Cases

Ankura on

The pharmaceutical industry faces escalating risks from sophisticated fraud schemes, including counterfeit drug distribution, billing irregularities, and corporate malfeasance. Forensic analytics—powered by AI and advanced...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

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