SAS/Trap Systems/Optenberg Team to Fight Medicaid Fraud

SAS Institute, a market leader in integrated data warehousing and decision support, announced an alliance with Trap Systems Inc and Optenberg & Associates to provide a comprehensive health care fraud control solution.

SAS' award-winning Enterprise Miner data mining solution, Trap System's comprehensive fraud detection and control software, VeriClaim, and Optenberg & Associates' Coordination of Benefits Evaluation System (CBES), have united to strengthen the attack on health care fraud that costs the U.S. an estimated $100 billion annually. The team's initial target is Medicaid fraud detection, with plans to expand into other areas of government-related health care fraud and abuse.

The team's superior fraud-fighting technology solution is the first in the market used to fight all levels of health care fraud, including false claims transactions, multiparty collusion, and other forms of criminal conspiracy. "We believe that successful fraud and abuse detection is the result of an integrated approach that combines technology, industry domain knowledge and experience," said George Rogers, vice president of business development at Trap Systems. "Our alliance with SAS solidifies and improves our ability to arm our customers with a powerful solution for fraud and abuse detection."

At the heart of VeriClaim is HOPS, a remarkably fast database engine that easily handles files in the multi-terabyte range. VeriClaim is uniquely able to detect anomalous patterns, collusive networks and other fraudulent schemes through sophisticated algorithms and high-speed performance capabilities. SAS' Enterprise Miner complements VeriClaim's offering by providing advanced data mining capabilities including neural nets and data visualization through an intuitive point-and-click environment. With Enterprise Miner, customers can further evaluate suspect claims identified by VeriClaim and develop new predictive models based on previously unobserved relationships in the data. CBES will then provide additional analysis of claims data in the following areas: coordination of benefits, subrogation, and patient eligibility quality.

"With Trap Systems' experience and leadership in the health care fraud detection market, SAS' expertise and leadership in the data mining field, and Optenberg's data analysis capabilities across multiple payer systems, our Team offers a stable robust solution for our present and future customers," said Jeff Babcock, vice president of public sector sales and marketing for SAS North America. "Our combined strengths will quicken the creation of new and unique analyses that will result in enormous nationwide government savings."

The team will make its debut at the NASO 2000-SURS On The Summit conference in Jackson Hole, Wyo.

About SAS

SAS Institute, one of the world's largest privately held software companies, is a leader in decision support and data warehousing, providing integrated enterprise information-delivery and e-business solutions. Founded in 1976, the company markets packaged business solutions for vertical industry and departmental applications, as well as an integrated suite of software tools and consulting services. These allow departments and agencies to transform the wide variety of data within their organizations into information that business users and researchers need to make better decisions. SAS software and services are used at more than 33,000 business, government and university sites in 110 countries. SAS' 1999 revenues totaled $1.02 billion.

About Trap Systems

Trap Systems established its unique position in the data processing market and has quickly become one of the industry's premier providers of Web-enabled integrity and financial solutions. Trap Systems has a proven track record of implementing its fraud control solutions to support numerous commercial, state and federal initiatives. Headquartered in Miami Lakes, Fla., Trap Systems is a wholly owned subsidiary of HOPS International Inc.

About Optenberg & Associates

Optenberg & Associates Ltd provides health care research, consulting and software expertise primarily focused in a number of areas of medical plan performance. Areas include (1) coordination of benefits (COB), (2) subrogation, (3) patient eligibility quality control and (4) beneficiary identity misuse/theft within and between one or more benefit systems. Optenberg & Associates, Ltd is considered one the nation's leaders in the use large data warehouses & mining directed toward the evaluation of system(s) of benefits with potentially overlapping benefits, enrollment, or simply geographic co-located coverage in the above areas of plan performance.

Contact SAS Institute Inc, Mary Ann Campbell-Hickland, 919-677-8000 x6997, MaryAnn.Hickland@sas.com.