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Behavioral Health Fraud Network Interactive MicroSim

Run the Behavioral Health Fraud Network Interactive MicroSim MicroSim Fullscreen

About This MicroSim

This MicroSim visualizes a patient-recruitment fraud ring of the kind seen in behavioral health. Recruiters (body brokers) refer out-of-state patients with commercial out-of-network insurance to treatment facilities; the facilities pay the recruiters per head (red kickback edges), house patients in a shared sober home, and over-order urine drug screens from affiliated labs, then bill the insurer. The closed financial loops, the near-total referral reciprocity, and the shared housing are exactly the structural signals a graph analysis flags as fraud.

How to Use

Study the node shapes and edge colors to see the scheme: orange referral edges from brokers to facilities, red dashed kickback edges flowing back, yellow lab-order edges, and purple housing edges to the shared sober home. Click any node to isolate its relationships and read its role in the investigation panel, and read the fraud-indicator summary (referral reciprocity, closed financial loops, out-of-state insurance) that distinguishes this ring from a legitimate referral network.

Iframe Embed Code

You can add this MicroSim to any web page by adding this to your HTML:

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<iframe src="https://dmccreary.github.io/modeling-healthcare-data/sims/behavioral-health-fraud-network-microsim/main.html"
        height="450px"
        width="100%"
        scrolling="no"></iframe>

Lesson Plan

Grade Level

9-12 (High School Geometry)

Duration

10-15 minutes

Prerequisites

TODO: List prerequisites.

Activities

  1. Exploration (5 min): TODO
  2. Guided Practice (5 min): TODO
  3. Assessment (5 min): TODO

Assessment

TODO: List assessment criteria.

References

  1. TODO: Add references.