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2022 Schemes Call for Presentation

2021 Call for Presentations: Schemes for Health Care Fraud Investigators & Analysts

The Schemes for Health Care Fraud Investigators & Analysts program is being held virtually from May 2 - 13. Submissions are due November 30. 

This annual program offers investigators - law enforcement and insurance - insights on detecting a variety of schemes through coding, analytics, and other red flags. 

Some topics the E&T Committee are interested in include:
  • Cardiology Schemes & Genetic Testing
  • COVID-19 Surveillance Testing
  • Electronic Prescribing Fraud
  • Health Information Technology Fraud (e.g., glucose monitors)
  • Traditional Fraud Areas:
    • Behavioral Health
    • DME
    • Labs
    • Outpatient facilities
    • Pharmacy
    • Telehealth
  • Schemes in Other Areas

Submissions should focus on:
  • Detailed explanations of how a scheme operates.
  • Red flags for schemes, including analytics, coding and/or modifiers, medical record review, etc.
  • Investigative strategies for a scheme or specialty area.
  • Examine schemes from a medial perspective. Discuss how the procedure would typically operate, explain how fraud and abuse occurs, and how the medical perspective can be incorporated into investigative strategy.  
  • Discuss ways to process information and apply it to their own claims data and investigations.

Questions can be directed to kbaker@nhcaa.org.
1. Are you one of the speakers?  *This question is required.
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Even though you are not a speaker, as the submitter, you will be considered the primary contact during the selection phase. The people on whose behalf you are submitting should know about, and approve of, this submission. 
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