Understanding Pharmacy Claims

Examine pharmacy fraud through each step in the life cycle of a claim. Scrutinize areas susceptible to fraud, and review common and emerging schemes, red flags and investigative strategies. Understand the critical role of Pharmacy Benefit Managers and learn ways to create a partnership against pharmacy fraud.

After completing this course

Available Session

June 18 | 1:00 pm EDT
Register Online | Download Registration Form

Faculty

Anne Sayther, CCSA
Director, Pharmacy Audit
Prime Therapeutics, LLC

Hannah Kokesh
Senior Lead Pharmacy Auditor
Prime Therapeutics, LLC

 Level/Credit

Level II program
2 CPEs

Investigating Mobile Services

Understand schemes, learn investigative techniques, and discuss coding and medical record review for a variety of mobile services such as diagnostics, general wellness, behavioral health, cardiology, and vision.

In addition, hear a case study on mobile dental units targeting low income housing, head start programs, mental health group homes and elementary schools. The units did not have running water, properly qualified personnel, or safety and quality protocols. The investigators will demonstrate a variety of fraud schemes used to perpetrate the crimes, and the data analysis and investigative skills used to build the evidence for conviction.

Available Sessions

July 9 | 1:00 pm EDT
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August 15 | 1:00 pm EDT
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Faculty

William (Robert) Banter, AHFI, CFE
Auditor, Indiana Medicaid Fraud Control Unit

Sheila Green
Special Agent, U.S. Department of Health & Human Services, OIG-OI

Preparing to be Deposed

Depositions occur during the discovery phase of a case; while an investigator may not ultimately testify in court, many go through the deposition process. Attorneys will discuss the steps of the proceeding along with critical preparation to ensure a smooth and successful deposition.

Available Sessions

October 2 | 1:00 pm EDT
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October 17 | 2:00 pm EDT
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Faculty

TBA

Each additional line is $79.00.

*Tuition-Free Registrations: Dues paying Member Organization can designate up to two tuition-free registrations per program. Dues paying Affiliate Members can designate one tuition-free registration per program. All Individual Members, Law Enforcement Liaisons, Premier Supporting and Supporting Members and non-members, including state and local, state and federal public agencies, wishing to participate will need to submit a registration form and applicable payment. All participants may purchase additional lines.

¹Member Rate applies to all NHCAA Member Organizations, Affiliate Members, Individual Members, Premier Supporting Members and Supporting Members.

²Government Rate applies to NHCAA Law Enforcement Liaisons and other attendees from local, state and federal public agencies.

³ Non-Member participants must occupy a professional position with a private for-profit or not-for-profit health care reimbursement organization, in a local, state or federal law enforcement, prosecutorial, a regulatory agency or in a professional disciplinary organization. All registrations will be reviewed to ensure these eligibility requirements are met. If you are not in one of these positions, but wish to attend, please email us at: training@nhcaa.org.

1. Register Online: If you are paying to attend (not utilizing tuition-free seats) you can use the links in the program section above to register online.
2. Fax: Fill out & print completed registration form. Fax form along with credit card payment information or purchase order to 202.785.6764.
3. Email: Email your completed registration form along with purchase order to training@nhcaa.org
4. Mail: Fill out & print completed registration form. Mail form along with payment information to NHCAA, 1201 New York Avenue, NW, Suite 1120, Washington, DC 20005. Make check payable to "The NHCAA Institute"

Registration Policies

Substitution
To request a substitution, you must provide WRITTEN NOTICE OF SUBSTITUTION to the NHCAA Institute 24 hours before the webinar is scheduled. Please email training@nhcaa.org to request a substitution.

Cancellation
For paying registrants, to cancel and obtain a full refund you must provide WRITTEN NOTICE OF CANCELLATION to The NHCAA Institute 24 hours before the webinar is scheduled. If you cancel in writing after that date, but before the program begins, you will receive a 50% refund, minus a $25.00 administrative fee. No refunds will be provided for cancellations received after the program convenes.

To cancel please email training@nhcaa.org or mail to The NHCAA Institute NETS Registration at 1201 New York Ave., NW, Suite 1120, Washington, DC 20005.

Full Adobe Connect Tech Specs

Equipment Requirements: In order to participate in the Webinar you must have two separate connections; one telephone line with Touch-Tone or one cellular telephone for the audio connection and a separate connection for Internet access.

Minimum PC and Browser Requirements: MS Windows 98, ME, NT4 (workstation or server), 2000PRO, XP Home Pentium 233Mhz, 128 MB RAM, 1024X768 screen resolution recommended.

Internet Connection: at least a 56K modem required, Microsoft Internet Explorer (IE). The Webinar will not work with AOL versions, users will need to minimize AOL and open IE.

Minimum Java Requirements: Microsft VM 1.1.4 or Sun JAVA 1.4.2_04. Internet Explorer Java permissions should be set at no higher than ìMediumî.

Customer support will be available one week prior to the event. Your confirmation email will have more information and details on how to access customer support.