Palantir at the Intersection of Extremists and Prescription Fraud

January 5, 2022

Blogger Ron Chapman II, ESQ, seems to be quite the fan of Palantir Technologies. We get that impression from his post, “Palantir’s Anti-Terror Tech Used to Fight RX Fraud.” The former Marine fell in love with the company’s tech in Afghanistan, where its analysis of terrorist attack patterns proved effective. We especially enjoyed the rah rah write-up’s line about Palantir’s “success on the battlefield.” Chapman is not the only one enthused about the government-agency darling.

As for Palantir’s move into detecting prescription fraud, we learn the company begins with open-source data from the likes of census data, public and private studies, and Medicare’s Meaningful Use program. Chapman describes the firm’s methodology:

“Palantir then cross-references varying sets of Medicare data to determine which providers statistically deviate from the norm amongst large data sets. For instance, Palantir can analyze prescription data to determine which providers rank the highest in opiate prescribing for a local area. Palantir can then cross-reference those claims against patient location data to determine if the providers’ patients are traveling long distances for opiates. Palantir can further analyze the data to determine if the patient population of a provider has been previously treated by a physician on the Office of Inspector General exclusion database (due to prior misconduct) which would indicate that the patients are not ‘legitimate.’ By using ‘big data’ to determine which providers deviate from statistical trends, Palantir can provide a more accurate basis for a payment audit, generate probable cause for search warrants, or encourage a federal grand jury to further investigate a provider’s activities. After the government obtains additional provider-specific data, Palantir can analyze specific patient files, cell phone data, email correspondence, and electronic discovery. Investigators can review cell phone data and email correspondence to determine if networks exist between providers and patients and determine the existence of a healthcare fraud conspiracy or patient brokering.”

Despite his fondness for Palantir, Chapman does include the obligatory passage on privacy and transparency concerns. He notes that healthcare providers, specifically, are concerned about undue scrutiny should their patient care decisions somehow diverge from a statistical norm. A valid consideration. As with law enforcement, the balance between the good of society and individual rights is a tricky one. Palantir was launched in 2003 by Peter Theil, who was also a cofounder of PayPal and is a notorious figure to some. The company is based in Denver, Colorado.

Cynthia Murrell, January 5, 2022

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