Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Living Innovations Support Services LLC

Day Training Developmentally Disabled Services·Dover, NH·NPI: 1932749512SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Cost Outlier

Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 3.1x in 2021-11

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $919.89 per claim for S5140 (Foster care, adult; per diem) — 3.6× the national median of $252.32.

This is a statistical summary, not an accusation. See our methodology.

Compared to Day Training Developmentally Disabled Services Peers

Total spending distribution among 22 providers in this specialty

P25MedianP75P90

This provider's total spending of $129.3M is at the 50th percentile among 22 Day Training Developmentally Disabled Services providers.

Active Billing Period:2020-042024-12(57 months)

Total Paid

$129.3M

$129,273,293

Total Claims

224K

Beneficiaries

41K

5.5 claims/patient

Avg Cost/Claim

$576

#898 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Living Innovations Support Services LLC is a Day Training Developmentally Disabled Services provider based in Dover, NH. From the 2018–2024 period, this provider received $129.3M in Medicaid payments across 224K claims.

Why This Matters

This provider received $129.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,159 Medicaid beneficiaries for a full year at average per-enrollee costs.

1180% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2020
$2.9M
+586%
2021
$19.8M
+61%
2022
$32.0M
+17%
2023
$37.6M
-2%
2024
$37.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 7 distinct procedure codes. The top code (S5140 (Foster care, adult; per diem)) accounts for 77% of total spending.

S5140Top 25%

Foster care, adult; per diem

$99.9M

109K claims · 77.2%

Your Cost: $919.89/claim|Median: $252.32
3.6× median
T2021Normal range

Day habilitation, waiver; per 15 min

$15.6M

53K claims · 12.1%

Your Cost: $294.43/claim|Median: $150.51
2.0× median
T2017Normal range

Habilitation, residential, waiver; 15 min

$11.7M

54K claims · 9.1%

Your Cost: $218.58/claim|Median: $137.32
1.6× median
H2023Top 10%

Supported employment, per 15 min

$2.0M

7K claims · 1.5%

Your Cost: $280.31/claim|Median: $103.94
2.7× median
T2019Normal range

Habilitation, prevocational, waiver; per 15 min

$61K

1K claims · 0.0%

Your Cost: $41.62/claim|Median: $88.91
0.5× median
T2035Normal range

$12K

225 claims · 0.0%

Your Cost: $52.22/claim|Median: $295.07
0.2× median
G9012Normal range

Other specified case management service, per 15 minutes

$0

201 claims · 0.0%

Your Cost: $0.00/claim|Median: $137.85