Board expands use of Torchlight analytics to detect Medicaid provider fraud

The State Board of Examiners on May 12 approved an amendment to a contract with vendor Pulse Light to expand use of a fraud-detection tool called Torchlight analytics for Medicaid provider oversight.

Board staff described the change as an expansion of an existing system that helps detect anomalies in billing and claims. “This new tool, specifically called Torchlight analytics, allows us to almost in real time catch anomalies in billing and claims, and allows our team to turn off payments now really quickly ahead of time so we stop money going out the door,” said Stacy Weeks, Board of Examiners staff. Weeks told the board the technology also provides a case-management function to prepare investigations for the Attorney General’s Medicaid Control Fraud Unit.

When asked whether the system was already in place, Weeks said it is: “It is on now. We’ve had it on for about 12 months. This just expands our ability to continue working with this vendor to add on additional benefits for the technology that we’re using. Already we’ve seen millions in savings to the state and the federal government from this product.”

A board member framed the amendment as part of the state’s broader effort to respond to provider fraud, and the board voted to approve contracts 1–56, which included the Pulse Light amendment (contract No. 37), by voice vote.

The board did not provide a detailed break‑out in the meeting materials of projected additional savings tied to this specific expansion, nor did any member request to withhold approval pending further audit results. The amendment was presented as an extension and enhancement of an existing engagement rather than a new procurement.

What happens next: the board approved the contract amendment during its motion to approve contracts 1–56; staff indicated the Medicaid Inspector General’s Office and the Attorney General’s Medicaid Control Fraud Unit will continue to use the system in investigations.