A PRIVATE-PUBLIC PARTNERSHIP AGAINST HEALTH CARE FRAUD
In today’s health care landscape, remuneration provided in exchange for patient referrals has taken a new approach. Although traditional “pay-to-play” schemes are still around, they have evolved, becoming more complex and difficult to identify. Through examples of kickback cases in the health care industry that were successfully investigated and prosecuted, along with current trends being seen across the country, the audience will be given a variety of pointers, techniques, and advice, including charging decisions when commercial health care plans are affected.
A discussion of emerging trends in kickback investigations will be also be presented, including the use of MSOs, rural hospitals (pass-thru billing) and shell companies that are used to disguise the true objective of the kickback arrangement, along with suggestions and tips on how to best identify, investigate and charge them.
Assistant United States Attorney | U.S. Attorney’s Office, Eastern District of Texas
Special Agent | U.S. Dept. of Health & Human Services, Office of Inspector General
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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 for 1.5 CPEs and NASBA 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
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National Health Care Anti-Fraud Association Headquarters
1220 L Street, NW, Suite 815 | Washington, DC 20005 | Phone: 202.659.5955 | Fax: 202.785.6764