Electronic fraud detection in the U.S. Medicaid Healthcare Program: lessons learned from other industries

It is estimated that between $600 and$850 billion annually is lost to fraud, waste, and abuse in the US healthcare system,with $125 to$175 billion of this due to fraudulent activity (Kelley 2009). Medicaid, a state-run, federally-matchedgovernment program which accounts for roughly one-quarter of all healthcare expenses in the US, has been particularlysusceptible targets for fraud in recent years. With escalating overall healthcare costs, payers, especially government-runprograms, must seek savings throughout the system to maintain reasonable quality of care standards. As such, the need foreffective fraud detection and prevention is critical. Electronic fraud detection systems are widely used in the insurance,telecommunications, and financial sectors. What lessons can be learned from these efforts and applied to improve frauddetection in the Medicaid health care program? In this paper, we conduct a systematic literature study to analyze theapplicability of existing electronic fraud detection techniques in similar industries to the US Medicaid program

The Challenges in SDN/ML Based Network Security : A Survey

Machine Learning is gaining popularity in the network security domain as many more network-enabled devices get connected, as malicious activities become stealthier, and as new technologies like Software Defined Networking (SDN) emerge. Sitting at the application layer and communicating with the control layer, machine learning based SDN security models exercise a huge influence on the routing/switching of the entire SDN. Compromising the models is consequently a very desirable goal. Previous surveys have been done on either adversarial machine learning or the general vulnerabilities of SDNs but not both. Through examination of the latest ML-based SDN security applications and a good look at ML/SDN specific vulnerabilities accompanied by common attack methods on ML, this paper serves as a unique survey, making a case for more secure development processes of ML-based SDN security applications.Comment: 8 pages. arXiv admin note: substantial text overlap with arXiv:1705.0056

CONDOR: A Hybrid IDS to Offer Improved Intrusion Detection

Intrusion Detection Systems are an accepted and very useful option to monitor, and detect malicious activities. However, Intrusion Detection Systems have inherent limitations which lead to false positives and false negatives; we propose that combining signature and anomaly based IDSs should be examined. This paper contrasts signature and anomaly-based IDSs, and critiques some proposals about hybrid IDSs with signature and heuristic capabilities, before considering some of their contributions in order to include them as main features of a new hybrid IDS named CONDOR (COmbined Network intrusion Detection ORientate), which is designed to offer superior pattern analysis and anomaly detection by reducing false positive rates and administrator intervention

Artificial intelligence and UK national security: Policy considerations

RUSI was commissioned by GCHQ to conduct an independent research study into the use of artificial intelligence (AI) for national security purposes. The aim of this project is to establish an independent evidence base to inform future policy development regarding national security uses of AI. The findings are based on in-depth consultation with stakeholders from across the UK national security community, law enforcement agencies, private sector companies, academic and legal experts, and civil society representatives. This was complemented by a targeted review of existing literature on the topic of AI and national security. The research has found that AI offers numerous opportunities for the UK national security community to improve efficiency and effectiveness of existing processes. AI methods can rapidly derive insights from large, disparate datasets and identify connections that would otherwise go unnoticed by human operators. However, in the context of national security and the powers given to UK intelligence agencies, use of AI could give rise to additional privacy and human rights considerations which would need to be assessed within the existing legal and regulatory framework. For this reason, enhanced policy and guidance is needed to ensure the privacy and human rights implications of national security uses of AI are reviewed on an ongoing basis as new analysis methods are applied to data

An Immune Inspired Approach to Anomaly Detection

The immune system provides a rich metaphor for computer security: anomaly detection that works in nature should work for machines. However, early artificial immune system approaches for computer security had only limited success. Arguably, this was due to these artificial systems being based on too simplistic a view of the immune system. We present here a second generation artificial immune system for process anomaly detection. It improves on earlier systems by having different artificial cell types that process information. Following detailed information about how to build such second generation systems, we find that communication between cells types is key to performance. Through realistic testing and validation we show that second generation artificial immune systems are capable of anomaly detection beyond generic system policies. The paper concludes with a discussion and outline of the next steps in this exciting area of computer security.Comment: 19 pages, 4 tables, 2 figures, Handbook of Research on Information Security and Assuranc