Ph.D. student Musheer Ahmed took home first-place honors and a $3,000 check from the Institute for Information Security & Privacy's "Demo Day Finale" for his data mining algorithm called "FraudScope" that helps detect Medicare fraud.

Ahmed examined two-years worth of Medicare claims data and found that his algorithm could accurately select which providers would be caught and indicted for healthcare fraud -- validating the technique as a risk predictor without the need for whistleblowers.

He and his faculty advisor, Prof. Mustaque Ahamad, have filed a provisional patent for the research and intend to form a private company. They anticipate that insurance providers and government healthcare programs will be most interested in the tool, which assigns risk scores to healthcare providers who are most likely to file fraudulent claims. He will use the prize money to help develop a software interface.

Ahmed believes that criminals who file fake medical claims for money are causing healthcare costs to rise for all Americans. In nearly a decade, the FBI's healthcare fraud team has charged more than 2,300 defendants who collectively falsely billed Medicare more than $7 billion. 

"If we catch the bad guys, we can lower healthcare costs," Ahmed says, who adds that most Americans don't realize healthcare identity fraud is a much bigger problem -- and harder to correct -- than stolen credit cards.

Venture capitalists and business leaders who served as judges at the Demo Day Finale picked Ahmed as the winner from among five student teams.

Investing in quality student work is an easy decision, said judge Paul Conley, managing director of the Paladin Capital Group.

"We're able to very efficiently deploy a little bit of capital alongside an entrepreneur, help them develop those ideas," he said after the event. "The ones that really achieve some traction or commercial success, we like to really get behind and back them as far as we can take them."

Also winning a cash prize at the Demo Day Finale was the research project, "Tying Public Key to Person with IDforWeb." Graduate students Yeongjin Jang and Mark Wisneski --  working with research scientist Pak Ho Chung -- received $2,000 to continue their work to help make public key infrastructure easier and more intuitive to use. The group aims to explore creative new ways for individuals to record and announce their public key for user-friendly verification.

As for Ahmed, he says he has been interested in healthcare fraud and cybersecurity since he was an undergrad studying computer science at Georgia Tech; it will remain his focus.

“I took an information security class the last semester of my degree, and I knew this is what I wanted to do.”

His PhD studies have been entirely focused on the problem of healthcare identity fraud. Now he is about to complete his doctoral degree on May 6 and immediately will turn his attention to developing FraudScope as a business -- right here in Atlanta.

11Alive News (WXIA-TV Atlanta)

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