Content at the ATC is organized into tracks to help guide your learning experience. Pick a track that best builds your skills and helps you work your caseload.
Clinical Issues for the Health Care Fraud Investigator
Sessions will increase the attendee’s understanding of clinical elements of an investigation including what to look for in documentation and specific codes. The faculty will focus on how to investigate issues including genetics, physical therapy and telemedicine as well as translating the findings into your organizations medical policy.
Expanding Your Investigative Skills
Sessions focus on how to build the investigative skills of the staff in the SIU units within the insurer community as well as law enforcement. Speakers will address how to build skill sets for staff and teams such as data analytics, interviewing, preparing and presenting a case, and assessing referrals.
Fraud in the Federal and State Programs
Faculty will discuss the schemes and challenges unique to the Medicaid and Medicare programs. Sessions in this track will examine fraud issues such as MCO Medicaid fraud, home health fraud and vision services fraud. In addition, faculty will highlight best practices in preparing for CMS audits, managing parallel proceedings, and analyzing data.
Pharmacy and Part D Fraud
The rampant abuse of opioids and the subsequent fraudulent activity will be the focus of this track. Sessions will focus on law enforcement cases prosecuted against pill mills, over-prescribers, substance abuse treatment facilities, and sober homes. Faculty will look at the challenges with obtaining patient records and patient harm associated with these cases.
Fraud in Specialty Products from Workers’ Compensation and Disability Insurance to Dental Fraud
Faculty will highlight strategies and surveillance activities for uncovering common schemes in supplemental products including disability insurance, long-term care insurance and workers’ compensation. Other sessions will spotlight current common dental fraud schemes and sleep apnea.
Trending Schemes in Health Care Fraud: Law Enforcement Case Studies
Our law enforcement agents and investigator audience will be interested in hearing case studies from their federal and state colleagues. Case studies will address leading health care fraud schemes including hospice fraud, behavioral health, medical device manufacturers, and radiology.
Fraud Fighting Solutions
Anti-fraud solutions providers assemble in the Expo and speak in sessions to offer attendees insights and best practices on fighting fraud with their innovative technology and tools.