Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: The well-known examples of predictive modeling “successes” are numerous. Perhaps less widely recognized is the myriad of ways in which a predictive model can fail to perform as expected, often due to misconceptions or misrepresentations on the part of the analyst. This article, which is intended for a general actuarial audience, focuses on three such pitfalls. By understanding these three common pitfalls, readers may guard against them within their own work, teams, and organizations.