A PRIVATE-PUBLIC PARTNERSHIP AGAINST HEALTH CARE FRAUD
This annual webinar will highlight the newest NHCAA Award, Specialty Benefits Investigation of the Year, which recognizes the substantial health care antifraud contributions by NHCAA Member Organization specialty benefit plans’ investigation units. While not all investigations lead to criminal or civil prosecution, they can result in significant policy or procedural changes that should be recognized. These changes may positively impact the effectiveness and efficiency of specialty benefit plans operations which, in turn, may improve the delivery of benefits to their clients.
In this webinar, the awardees of the 2022 Specialty Benefits Investigation of the Year will break down the investigative steps and results of their case. Blue Shield of California’s Special Investigations Unit began their investigation in February 2020 upon receiving information that Eargo Hearing, Inc., a hearing aid company, was using unlicensed individuals to provide medical consultation services and was giving medically unnecessary hearing aids to members and their beneficiaries who were enrolled in the Federal Employee Health Benefit Program/Federal Employee Program (FEBHBP/FEP).
Related schemes were uncovered by the United States Office of Personnel Management, Office of the Inspector General, Office of Investigations. Approximately $48 million was billed by Eargo between January 2017 and February 2022 for which they received reimbursement of $33.5 million. A civil action was filed by the Department of Justice under the False Claims Act, and in April 2022, Eargo agreed to pay $34.7 million to settle the case.
Lawrence GardSpecial Agent, United States Office of Personnel Management
Jonnie Massey, CPC, CPC-P, CPC-I, CPMA, AHFISenior Director, SIU | Blue Shield of California
Webinar programs are most appropriate for beginning and mid-career analysts, investigators, consultants, and law enforcement agents working in the health care anti-fraud industry.
As a level II, or intermediate program, some investigative / health care / coding expertise is assumed. Training content is focused on the detection and investigative processes, using case examples to highlight strategy and techniques.
There are no pre-requisite requirements to attend webinar programs.
View our updated FAQ webpage to see if your webinar question has already been answered. If not, email the education team at email@example.com.
National Health Care Anti-Fraud Association Headquarters
1220 L Street, NW, Suite 815 | Washington, DC 20005 | Phone: 202.659.5955 | Fax: 202.785.6764