Kyle Mack

189 posts

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Kyle Mack

Kyle Mack

@KyleTMack

CEO of @MiddeskHQ

New York, NY Присоединился Ağustos 2013
305 Подписки1.4K Подписчики
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Kyle Mack
Kyle Mack@KyleTMack·
Yesterday we posted what @MiddeskHQ found when we cross-referenced the @DOGE_HHS dataset against our business identity infrastructure. 300K+ views later, people are asking: what does this fraud actually look like up close? 🧵
Kyle Mack tweet media
Kyle Mack@KyleTMack

HHS just open-sourced the largest Medicaid dataset in history. About $1T in claims data, free for anyone to analyze via @DOGE_HHS. Everyone's looking at what was billed. At @MiddeskHQ, we're looking at who's behind the billing. Here's what we found 🧵

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Kyle Mack
Kyle Mack@KyleTMack·
@typesfast What do you think will be the ways fraud will happen through the broader refund process?
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Ryan Petersen
Ryan Petersen@typesfast·
We're enrolling companies be the first in line to process for tariff refunds start happening. 22 Fortune 500 Companies signed up to get into the process yesterday. We've made the process dead simple and free to enroll. When the window opens, we will be the fastest, most accurate, and most affordable way to get refunds in the world.
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Kyle Mack
Kyle Mack@KyleTMack·
@imthemusic This is only one narrowly defined fraud pattern related to paying out to blacklisted providers
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Roseanne Wincek
Roseanne Wincek@imthemusic·
I am going to get lambasted for this, but.... $1.09T in payments of which ~$2.3B was fraudulent. I know $2.3B is a lot of money, but that means that $1.087T was not fraudulent. So Medicaid had a 0.2% fraud rate. Fraudsters gonna fraud - how is medicaid so good at preventing it?
Kyle Mack@KyleTMack

From 2018–2024, $1.09T in Medicaid payments went to ~1.6M providers. The biggest category was personal care services (in-home visits) at $122B. The fastest growing was behavioral health/substance abuse claims, up 450%+ over 5 years.

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Kyle Mack
Kyle Mack@KyleTMack·
HHS just open-sourced the largest Medicaid dataset in history. About $1T in claims data, free for anyone to analyze via @DOGE_HHS. Everyone's looking at what was billed. At @MiddeskHQ, we're looking at who's behind the billing. Here's what we found 🧵
Kyle Mack tweet media
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dj patil
dj patil@dpatil·
Started in Obama with Data.gov and the exec order that all federal data by default should be open and machine readable. Then much of it was put into law during Trump 1. It’s taken far too long to get this out. And needs much more augmentation/cleaning. Good start, far from done
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Kyle Mack
Kyle Mack@KyleTMack·
At @MiddeskHQ we do this every day for banks and fintechs. The same tools can protect public programs. DM me or reach out at kyle@middesk.com
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Kyle Mack
Kyle Mack@KyleTMack·
This is one cluster. Across our analysis, we found networks of providers totaling $1.7B in Medicaid payouts linked through shared addresses, officers, and formation patterns. The truth is mapping these connections is difficult, it requires broad data access, tooling, and strong analytical research.
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Kyle Mack
Kyle Mack@KyleTMack·
Yesterday we posted what @MiddeskHQ found when we cross-referenced the @DOGE_HHS dataset against our business identity infrastructure. 300K+ views later, people are asking: what does this fraud actually look like up close? 🧵
Kyle Mack tweet media
Kyle Mack@KyleTMack

HHS just open-sourced the largest Medicaid dataset in history. About $1T in claims data, free for anyone to analyze via @DOGE_HHS. Everyone's looking at what was billed. At @MiddeskHQ, we're looking at who's behind the billing. Here's what we found 🧵

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Zach
Zach@zachterrell57·
Awesome Something to keep in mind: with the “cell suppression” policy (dropping rows with small claim counts), we lose ~80% of the data, so the actual total $ amount is much higher Working on ways to lower that cell suppression threshold so we can release a larger version of the dataset
Kyle Mack@KyleTMack

HHS just open-sourced the largest Medicaid dataset in history. About $1T in claims data, free for anyone to analyze via @DOGE_HHS. Everyone's looking at what was billed. At @MiddeskHQ, we're looking at who's behind the billing. Here's what we found 🧵

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Kyle Mack
Kyle Mack@KyleTMack·
If you're a journalist, researcher, or data analyst looking at this data we'd love to help. DM me or reach out at kyle@middesk.com Fraud hides in identity. Let's find it.
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Kyle Mack
Kyle Mack@KyleTMack·
This is just a conservative pass of blacklisted providers, revoked licenses, and the businesses directly connected to them. There's much more to dig into: anomalies in average claim sizes, geographic clustering, further validation of individual provider legitimacy.
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