Top Schemes of 2021

Based on a review of member investigations and feedback from our committees and leaders, NHCAA has selected COVID-19, telehealth fraud, and cardiac genetic testing as the topics for the 4th annual Top Schemes webinar. Participants will hear strategies to detect, investigate, and prevent fraud in all three areas. Detailed descriptions can be found below.

COVID-19 Schemes

Discuss schemes seen throughout 2021 for preventing and curing COVID-19.

Mark Horowitz, RPh
Sr. Manager, Investigations
Kaiser Permanente

Telehealth Fraud

Prior to the COVID-19 pandemic, no one could foresee telehealth would be the new norm. This discussion of trends and recent cases will focus on proactive strategies in regard to telehealth claims. Speakers will review their 2021 tactics and recent cases, including behavioral health examples, and will explain their plans for 2022.

Tanya Pennington, CFE
Senior Manager – SIU Investigations,
Magellan Health

Patty Marth, CFE
Senior Compliance/Claims Auditor, Special Investigations Unit
Magellan Health

Cardiac Genetic Testing

This presentation will begin with a discussion of appropriate genetic testing use as well as proper protocols, helping investigators recognize potential red flags in their own claims data. Speakers will then examine, through case studies, several of the schemes they have encountered including coding concerns, ordering physician problems, and telemarketing issues.

Elsabe Meyer, JD
Lab Team Manager, Special Investigations Unit
Humana, Inc.

Marissa Russell, MS, CGC
Genetics Lead, Humana SIU Clinical Team
Humana, Inc.

Lauren Baggett, MS, CGC
Genetics Manager – Humana SIU Clinical Team
Humana, Inc.

Registration Information

REGISTRATION RATES

Dues paying Member Organizations can designate up to two tuition-free registrations per webinar. Government Liaisons and Platinum and Premier Supporting Members can designate one tuition-free registration per webinar. All Individual Members, Supporting Members, and non-members (including local, state, and federal public agencies who are not Liaisons) need to submit a registration form and applicable payment.
NHCAA Member1 Government2 Non-Member3
$175 $175 $250
For both Tuition-Free and paid registrations additional webinar lines are $100.

REGISTRATION POLICIES

Registration closes at 3:00 PM ET the day before the webinar.

Cancellation/Substitution

All cancellations (regardless of date) will be assessed with at $25 administrative fee. All written notice of cancellations and substitutions should be sent via email to training@nhcaa.org. Cancellations must be received in writing 24 hours in advance of the webinar in order to receive any refund.

Concerns

For more information regarding administrative policies such as refunds, cancellations and complaints, please email training@nhcaa.org.

Details & FAQ

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.

All webinars are approved by: NHCAA, NASBA and AAPC for 1.5 CPEs. Participants earn 1.5 Continuing Professional Education (CPE) hours applicable to the training requirements for the Accredited Health Care Fraud Investigator (AHFI®) designation.
The NHCAA Institute is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org. NASBA Field of Study: Specialized Knowledge & Applications.
AAPC Medical Coding CEU Approved Vendor*This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Webinars are delivered via Adobe Connect, one of the most secure virtual meeting platforms. You will need a computer, internet connection, and possibly a phone.

If this is your first time joining a meeting using Adobe Connect, please review our Technical Requirements & Troubleshooting for Adobe Connect webpage, which includes a link to test your system. Remember to download the Adobe Application for the best experience.

View our updated FAQ webpage to see if your webinar question has already been answered. If not, email the education team at programs@nhcaa.org.


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Date

Dec 09

Time

Eastern Time
2:00 pm - 3:30 pm
  • CPEs: 1.5
NHCAA

Organizer

NHCAA
Phone
202.659.5955
Email
training@nhcaa.org
Website
http://www.nhcaa.org

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