PPT-Significant Developments in Health Care Fraud

Feldman Firm PLLC ABA Health Law Section Member BENEFIT PARTS Iii May 20 2015 AND June 24 2015 OVERVIEW Major Government Enforcement Initiatives What to Anticipate Government Enforcement Trends . MPA Winter CE + Ski . January 12. th. , 2014. Jason Walker-Crawford, R.Ph. – PAAS National®, Inc.. Learning Objectives. Discuss the Medicare Part D requirements for Fraud, Waste & Abuse Compliance (FWAC).. Candidate 3. The three developments. Nitinol archwires in braces. Lingual Braces. Invisalign. What’s the Point…?. To correct malocclusions—Improper bites. Nitinol . Archwire. Shape Memory Alloy . A View from Social Care. Terry Dafter. Chair of ADASS Informatics Network. November 2014. Background and Challenges. Ageing population. Over . next 20 years, proportion of . population . 85+ . will more . ORGANIZATIONS:. (A different context for teaching about fraud. ). Mary Anne Atkinson. Cheryl . Prachyl. Carol . Sullivan. American Accounting Association Annual Meeting . Atlanta, Georgia August 2014. Medicare Fraud & Abuse: . Prevention, Detection, and Reporting. 2. Disclaimers. . This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently so links to the source documents have been provided within the document for your reference.. Researchers: Katie Cossette, MSOT/S’15. . Stacey . Dahm. , . MSOT/S’15. Stephanie Flower, . MSOT/S’15. Susan Goedeken, . MSOT/S’15. Merissa . Harkema. , OTD/S’16. Problem. Poor health behaviors are a significant contributor to illness and mortality.. . . Definition of Fraud. The . Institute of Internal Auditors’ IPPF defines . fraud . as:. . . . “. Any illegal act characterized by deceit, concealment, or violation of trust. These acts are not dependent upon the threat of violence or physical force. Frauds are perpetrated by parties and organizations to obtain money, property, or services; to avoid payment or loss of services; or to secure personal or business advantage.”. Social Networking. Holly Pu. Chief Statistician. Health Integrity, LLC. $190 Million Lost . to Fraud Per . Day. Every Day of The Year…. 2. Statistics about Health Care. In 2008, . $2.34 trillion. was spent on health care in. Senior Medicare Patrol. LTC Ombudsman Program . 2014-2015. . Funded by the U.S. . Department of . . Health & Human Services – . Administration on Community Living. Administration on Aging established 12 demonstration projects . Presented by Statewide Health Insurance Benefits Advisors (SHIBA), Washington state’s SMP SMP program funded by the U.S. Administration for Community Living Take Charge… Help Prevent Health Care Fraud and Abuse! Common Denominators, Universal Challenges. and. Perspective for CEOs. William J. Mahon. The Mahon Consulting Group, LLC. Setting. Shauna B. Itri, ESQ. . 267-973-4265. www.linkedin.com/in/shaunaitri/ . Speaker . Biography: . Shauna Itri . Shauna . represents whistleblowers in False Claims . Act law suits in state and federal courts throughout the United States, and tax and securities whistleblowers with claims under the IRS and SEC whistleblower programs. Ms. Itri received a B.A. and an M.A. from Stanford University, where she . Number of carers broadly stable as a proportion of population, but increasing hours of care provided (especially 50+ hours/week). This means value of care increasing.. By one estimate, if all hours of care were replaced by State at market rates would cost £132bn (Carers UK 2015). 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..