Finding Fraud in $1 Trillion of Medicaid Data with DuckDB
CMS recently published provider-level Medicaid spending data from T-MSIS — every fee-for-service, managed care, and CHIP claim from 2018 through 2024, aggregated by billing provider, procedure code, and month. 227 million rows. $1.09 trillion in payments. I wanted to see what falls out when you run some basic fraud heuristics against it. The dataset is available at opendata.hhs.gov/datasets/medicaid-provider-spending/. The dataset The download is a single 2.94 GB parquet file with seven columns: ...