PPT-GSIL Long Term Support Medicaid Fraud Update

Debbie Krider GSIL COO and Compliance Officer January 172017 What is Medicaid Fraud Being paid for services that have not been provided or have not been provided in a reasonable standard of quality care. No . recourse to public funds’ is an immigration condition applied to people entering the UK . as a condition . of . their entry. Applies to individuals such as visitors, overseas students, people who seek to remain on the basis of marriage, over-stayers and illegal entrants. My Background. :. Masters Degree from Columbia University. Licensed by the State of NY . ie. ; Licensed Clinical Social Worker (LCSW). Director of Admissions and Social Work in two Nursing Facilities. Frances . M. . Pantaleo, . esq.. BLEAKLEY PLATT & Schmidt, LLP. One North Lexington Avenue. White Plains, NY 10601. Tel: (914) 287-6118. fpantaleo@bpslaw.com. Continuum of Care. Home Care . Day programs (social and medical model). Auditing Acquisitions. For Fraud. 2. O. verview of the (DHS) acquisition process. Identify fraud schemes and their various indicators. Note where these occur within federal acquisitions. Discuss how we audit for them. Bob Applebaum. October 2017. Year 2000 2020 2040. Total Pop 11.4 11.7 11.7. (millions). 60 plus 1.9 (17%) 3.0 (25%) 3.4 (29%). Florida Crime Prevention Practitioner Update. Technology Today. Presented by . Jay . Toth. Presented By:. Jay . Toth. Crime Prevention HQ .com. Florida Crime Prevention Practitioner. Florida CPTED Practitioner. 2016 National Training Program. Session Objectives. This session should help you . Define fraud and abuse . Identify causes of improper payments. Discuss how CMS. fights fraud and abuse. Explain how you can fight fraud and abuse. F program that uses a streamlined patient - centered care model. What will FIDA do for you as a provider?  Provides extra support coordinating care for your patients through a Care Manager. T 2016 National Training Program. Session Objectives. This session should help you . Define fraud and abuse . Identify causes of improper payments. Discuss how CMS. fights fraud and abuse. Explain how you can fight fraud and abuse. Sara Rosenbaum, JD. March 8, 2017. Background. With total Medicaid enrollment approaching 75 million, high interest in delivery and payment reform. Managed care serves as the principal means for health care organization, delivery, and payment within the Medicaid program, increasingly across all beneficiary populations. Addressing the . Boomer Challenge. 2012 Health Policy Roundtables. 1. Today’s Discussion . The urgency of long term services and supports—what’s the hurry? . Changing demographics. A summary of LTSS. Members . eligible for Traditional Medicaid . include:. Children. Pregnant Women. Aged, Blind or Disabled Adults. Women eligible under the Cancer Program. Some services are available only to children and to pregnant women under Traditional . EXCEL MSO seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of health plans, federal, and state authorities in their enforcement of prohibitions of fraudulent practices by providers, members, or other entities dealing with the provision of health care services.. Page . 2. The Medicare Rights Center is a national not-for-. profit consumer service organization that works to . ensure access to affordable health care for older . adults and people with disabilities through.