August NETS

August 25 - 27
Westin Riverwalk | San Antonio, Texas

Case Discussion Roundtable Meeting
Registration Rates
Hotel Reservations & Travel Information
San Antonio-City


Functional Medicine: Fraud in Diagnostic Procedures & Treatment

August 25
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

Functional medicine aims to address underlying causes of chronic disease through the impact of lifestyle, genetic, and environmental factors. Many office services and procedures, as well as diagnostic and laboratory tests are used, across specialty areas, to identify causes of these chronic conditions. Faculty will review a variety of procedures, such as lab work on blood metal levels, allergies, hormones, and genetic screenings, as well as treatments like alternative medicine, supplements, detox, and prescription drugs.

Explore this emerging area, learn new schemes to bring back to your unit, and understand how these tests and procedures are being billed and under what circumstances may be considered inappropriate. Faculty will show participants how to recognize red flags in medical records, data, and coding and will highlight fraud issues through case studies.

Outpatient Facility Schemes

August 26
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

Explore fraud schemes unique to hospitals, skilled nursing facilities, ambulatory surgery centers, dialysis units, and other outpatient clinic settings. Examine common facility billing & coding schemes and understand what investigative strategies are most effective in these settings through case study examples. Learn how to interpret records and documentation associated with various facilities.

Responding to Provider Defenses

August 27
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

This program will prepare SIU investigators and law enforcement for common provider health care fraud defenses. Faculty will explain how to hone investigations to counter the most common, as well as the most complex, defenses and those unique to commonly billed specialty areas. Understand concerns with electronic records, sampling methodology/extrapolation, medical record norms, and common legal issues, including ERISA, and how to avoid common investigative pitfalls. Participants will also learn how to present findings to the provider and use findings in negotiations.

Case Discussion Roundtable

The Case Discussion Roundtable Meetings are by invitation only. If you are eligible* and would like to receive an invitation, please contact Brian Viggiano, Deputy Director of Anti-Fraud Initiatives.

These meetings provide an opportunity for private insurer members to come together with our public and law enforcement partners to share information and discuss active health care fraud investigations as well as schemes, trends, and fraud patterns.

Attendees participate in group discussions; sharing information on their active cases and trends they are experiencing.

Case Discussion Roundtable Meetings are held at each of the 2015 National Education & Training Series (NETS) programs, with the exception of the April program, and at the 2015 Annual Training Conference.

*Employees of NHCAA's Member Organizations that have signed an Information-Sharing Agreement and NHCAA's Law Enforcement Liaisons (LELs) are eligible to attend.

  Member1 Government2 Non-Member3
1 Program $395 $455 $595
2 Programs $770 $885 $1170
3 Programs $1,145 $1,325 $1,695

1NHCAA Member rate applies to all NHCAA Member Organizations, Affiliate Members, Individual Members, Platinum Members, Premier Supporting Members and Supporting Members.
2Government rate applies to NHCAA Law Enforcement Liaisons and other attendees from local, state and federal public agencies.
3Non-Member participants must occupy a professional position with a private for-profit or not-for-profit health care reimbursement organization, or in a local, state or federal law enforcement, prosecutorial, or regulatory agency or in a professional disciplinary organization. All registrations will be reviewed to ensure these eligibility requirements are met. If you are not in one of these positions, but wish to attend, please email us at:



4 Ways to Register

  1. Online: Register online via secure transactions. Please have a Visa, MasterCard, Discover or American Express card available
  2. Fax: Fill out & print completed registration form. Fax form along with credit card payment information or purchase order to 202.785.6764.
  3. Email: Email your completed registration form along with purchase order to
  4. Mail: Fill out & print completed registration form. Mail form along with payment information to NHCAA 1201 New York Avenue, NW, Ste 1120, Washington, DC 20005. Make check payable to "The NHCAA Institute".

Substitution & Cancellation Policy

Registration, Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7. NHCAA accepts registrations after this date; however, NHCAA may not be able to include your contact information in the participant roster or have a certificate of completion on-site for you.


To cancel and obtain a full refund, minus a $75.00 administrative fee, you must provide WRITTEN NOTICE OF CANCELLATION to The NHCAA Institute by the Registration, Substitution and Cancellation Cut-off Date (see above). If you cancel in writing after that date, no refund will be provided. To cancel please email the Manager, Education & Training Services, at or mail the NHCAA Institute - NETS at 1201 New York Ave., NW Suite 1120, Washington, DC 20005.


To request a substitution, you must provide WRITTEN NOTICE OF SUBSTITUTION to the NHCAA Institute by the Registration, Substitution and Cancellation Cut-off Date (see above). All substitutions received after the cut-off date will be assessed a $75.00 fee. Please email the Manager, Education & Training Services at to request a substitution or mail the NHCAA Institute - NETS at 1201 New York Ave., NW Suite 1120, Washington, DC 20005.



Westin Riverwalk
420 West Market St.
San Antonio, TX 78205

San Antonio


Negotiated Hotel Rate Cut-off: Tuesday, August 4, 5:00 pm CT

Regular rate attendees can also book online.

Government rate attendees can also book online.

Participants should identify themselves as being with the NHCAA National Education & Training Series (NETS). If you are a federal employee and qualify for the government rate, please also identify yourself as qualifying for the government block.

Room Rates

Standard Single: $159.00*
Government Single: $110.00* or prevailing government per diem.

Cost does not include a 16.75% in state and local taxes.

Reservations must be secured by one night's deposit or a major credit card. One night's charge will be applied to the individual's card for the first night's room/tax if the individual does not arrive on the designated arrival date or does not cancel their reservation 72 hours prior to their scheduled arrival date, or leaves earlier than the confirmed check out date.

Hotel Information

Check-in: 3:00 p.m.
Check-out: 12:00 p.m.

Internet: Complimentary up to $9.95 per day

Valet-parking only: $40 per day


San Antonio International Airport - SAT

  • Distance to hotel: 16 miles
  • Estimated taxi fare one-way: $40
  • Shuttle Service: $19.00 (per person, one-way) or $34.00 (per person, round-trip) 
  • SAT Website

*IMPORTANT: Website URLs, taxi fares, parking costs, check-in & check-out times, and other quoted prices and information may be changed at the vendors' discretion. Please confirm all costs associated with your travel prior to attending the program.