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Anyone who has spent time reviewing claim forms and bills submitted by medical providers has probably encountered at least some of the more typical fraud schemes: overbilling, false claims, or maybe even kickbacks and bribery. Sophisticated technology, investigative techniques, and data analytics let us zoom in – and out – to identify these traditional forms of fraud at the individual claim level and on a system-wide scale.

But a recent opinion by the New York Court of Appeals, the state’s highest court, should serve as a reminder to look out for a different sort of fraud that ...