Safeguarding Public Healthcare Spending with Explainable AI: A Statistically Validated Machine Learning Framework for Medicaid Fraud Detection and Electronic Visit Verification
Medicaid improper payments in the United States reached an estimated $37.39 billion (6.12%) in fiscal year 2025, up from $31.10 billion (5.09%) the prior year, with more than three-quarters attributable to insufficient documentation rather than confirmed fraud — precisely the gap that Electronic Visit Verification (EVV...