Call For Presentations
NHCAA is seeking health care anti-fraud professionals to share best practices, case studies, emerging schemes, investigative or clinical skills, proven data mining techniques, and investigative solutions at the following 2020 programs:
- Schemes for the Health Care Fraud Investigators & Analysts
- Enhancing Your Skills: Managing & Navigating complex Investigations
- Strengthening Your Data Analytics Strategies & Techniques
All submissions are due by Friday, January 31, 2020. The Annual Training Conference Call for Presentations will open in early 2020.
Travel reimbursements are changing for 2020. NHCAA will cover one night at the host hotel and $500 toward travel. Food and beverages will not be reimbursed. Employees of anti-fraud solution vendors will not be eligible for reimbursement.
Schemes for the Health Care Fraud Investigators & Analysts
Deadline: January 31
Each year NHCAA hosts a Schemes training offering investigators – law enforcement and health insurance - insights on detecting a variety of schemes through coding, analytics, and other red flags. During this three-day program, participants will hear detailed explanations of how a scheme operates so they can return to their office knowing how to find and investigate these schemes using their own claims data.
This program will be held June 16 – 18 in San Diego, California.
The Education & Training Committee is particularly interested in presentations that fit into one of the categories below. Schemes pertaining to commercial health insurance, supplemental insurance, and government programs, especially Medicare, Medicaid, and Medicaid Managed Care, are welcome.
Case study submissions should clearly outline how the case was identified, the role of data in the case, identify the parts of the scheme and corresponding steps of the investigation from beginning to end, explore collaborations and partnerships with other organizations/agencies, and, if applicable, explain relevant steps to preventing future fraud in this are
Submissions should include a description of methods used to identify/confirm the scheme, how data was used in the investigation, what codes were identified, and what can be replicated in other investigations. When submitting, provide the following information in the description:
- What data techniques were used to find or confirm the scheme?
- Who is the audience for the session - the investigator? analyst?
- What are the codes identified in this scheme (CPT, ICD-10, HCPCS, REV codes)?
Clinical, Coding, & Chart Review
Submissions in this category should advance an investigator or analyst’s understanding of health care fraud through clinical and/or coding knowledge. Review a procedure, discuss coding discrepancies, or show how chart review can be completed. Ideal presenters will hold medical credentials or coding credentials (CPC, CPMA, CPC-H, etc.) as NHCAA would like to provide credit through AAPC for this program.
Enhancing Your Skills: Managing & Navigating Complex Investigations
Deadline: January 31
This program is designed to enhance the skills of middle managers and investigators on the rise. Content focuses on the skills necessary for complex investigations.
Speakers, utilizing case studies, will unravel complex schemes through a focus on case management, internal collaboration, analytics, team development, and partnership with law enforcement. In addition, faculty will examine skills experienced anti-fraud professionals need, such as interviewing and negotiation, to conduct effective investigations.
This program will be held August 4 – 5 in Denver, CO.
The Education & Training Committee is particularly interested in presentations that fit into one of the categories below. Schemes and management techniques pertaining to commercial health insurance, supplemental insurance, and government programs, especially Medicare, Medicaid, and Medicaid Managed Care, are welcome.
In your submission description, please detail the case management skills needed to investigate your complex scheme. Sessions should emphasize ways to enhance and refine skills, ideally with examples of improved investigative outcomes, lessons learned, and habits investigators can adopt immediately. For skill-based sessions not reliant upon a scheme, unless the skill is unique, no foundation building sessions (i.e., Level I) will be accepted for presentation.
Advanced Investigative Skills & Management Techniques to Investigate
- Kickback arrangements
- Unique owner arrangements
- Birth tourism / medical tourism
- Direct marketing schemes
- Foreign claims
- Intraoperative neuromonitoring
- Virtual offices
Strengthening Your Data Analytics Strategies & Techniques
Deadline: January 31
This new two-day program, geared towards experienced analysts, combines lecture, facilitated group discussion, and hands-on programming. By walking through case examples, participants will practice data analysis strategies and techniques to uncover leads and fraud schemes. In addition, they will better understand how data can be used through all phases of an investigation. Faculty will share their best practices to maximize fraud, waste, and abuse analytics, organize and present data, and coordinate with internal and external stakeholders.
Participants will need to bring their own laptop for hands-on work.
This program will be held August 4 – 5 in Denver, CO.
The Education & Training Committee is particularly interested in presentations that fit into one of the session types below. Topics should be geared toward experienced analysts. Descriptions should summarize the key data challenge the presentation address.
Traditional presentation that describes a data challenge and a solution or methodology for addressing that concern or fraud scheme.
Speaker would introduce a topic and then lead the group in small and large group discussions so multiple viewpoints and examples can be heard and discussed.
Speaker would use a deidentified or created dataset provided to participants to show participants a strategy to manipulate data, run analysis, graph/visualize data, etc.
Please review the information below before submitting a presentation idea.
Who Should Submit
- Professionals in health care anti-fraud detection, investigation, prosecution, and prevention activities.
- If you are a consultant or vendor to the industry, we encourage you to use this opportunity to highlight your internal subject matter experts, anti-fraud initiatives, and solutions by including an NHCAA Member Organization presenter in your submission.
Planning Your Submission
- All submissions should include “how-to” content, best practices, and/or a diversity of perspectives. Product/company specific sales pitches will not be accepted by the review committee.
Sessions should be developed for a level II or III audience and should not include introductory or generic information for common fraud schemes. For emerging or difficult schemes this type of information is acceptable to include.
60, 75, or 90 minutes presentations. Consider number of speakers, how quickly each one presents, their prior speaking experience, the breadth and depth of material, and potential for questions, typically between five - ten minutes.
- Learning Objectives
Please provide three learning objectives. These statements specify what participants will learn during your session. Read more about how to create a learning objective.
In 500 words or less, clearly describe what materials the session will cover, explain any emerging facets or, if a common topic, why it should be revisited, any interactive or unusual aspects of the presentation, why participants will care about this topic, and, if necessary, expand on participant takeaways.
If submitting a case study, please explain why the case is significant. Key discussion points should be: how the case started, if multiple agencies or carriers who worked the case, the scheme being perpetrated, any unique attributes, lessons learned, and the status of the case. All case study presentations will need to include three takeaways for the audience.
Each presenter should submit a brief bio that includes speaking experience. In no more than 250 words please explain why you are qualified to speak and any relevant industry experience.
Submission Review Process
- The Education & Training Committee, comprised of approximately fifteen representatives from health plans and federal government agencies, will review each submission and determine if it is appropriate for presentation at one of the programs.
- The committee looks at the following criteria: overall quality, relevance to the industry, well-defined focus and learning objectives, practical application of material, timeliness of the topic, and speaker qualifications.
- Sales presentations and incomplete submissions will not be considered.
- Selections will be made approximately three months in advance of the program. All submitters will be notified of the committee’s decision on their submission(s).
Below is what NHCAA expects from speakers at our programs and what speakers can expect from the Association.
- Participate in conference calls with NHCAA staff to develop presentation content and discuss program logistics.
- Provide a PowerPoint presentation for the participant materials portal at least two weeks in advance of the program. All speakers, including those from law enforcement, must provide at least a title slide and a slide with the takeaways from the presentation for the portal.
- Rehearse presentation to ensure it fits within allotted time frame.
- Arrive onsite at least one hour prior to presentation start time.
- Deliver a quality presentation that aligns with the final advertised description and learning objectives. If presentation fails to meet this expectation, future invitations to speak will be jeopardized.
- Set aside a few minutes after the presentation to answer participant questions.
- Submit any reimbursement requests within 30 days of the program.
- Notify all individuals who submitted approximately three months in advance of an in-person program.
- Coordinate conference calls and deliver timely guidance and feedback to ensure a successful presentation.
- Listen to speaker needs and provide appropriate audio/visual equipment and other necessary materials.
- Provide a complimentary, non-transferable program registration and access to program materials.
- Facilitate presentations onsite and assist with any onsite speaking or logistics needs.
- Reimburse, if applicable, speaker travel and hotel costs per our travel policy. (coming soon)