Schemes for Health Care Fraud Investigators & Analysts

At this time, NHCAA plans to host our Schemes program June 16-18 in San Diego, California. However, the protection of our attendees’ health is our first priority. NHCAA will continue to monitor the situation with COVID-19, including the timeframe for California’s stay at home and social distancing requirements, the status of domestic air travel, and the travel restrictions imposed by our members on their teams.

The agenda will be filled with sessions dissecting schemes from across the health care industry. Participants will hear how their peers uncovered schemes through data mining, incorporated analytics into their investigation, utilized red flags to discover fraud scheme mechanics, and evaluated different strategies to investigate fraud.

By better understanding the schemes, participants will know what to look for in their own data and how to structure their investigations.

*Click the corresponding tab to view detailed information.

From data mining and interpretation to clinical considerations and investigative strategy, 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.

View Schedule-at-a-Glance for this program. 

Three Educational Session Types

Scheme Development
Examine variety of topics that focus on the intricacies of how a scheme operates and fosters an understanding of the fraud scheme. Speakers will explain the data analysis, clinical and billing/coding aspects, highlight challenges, and review investigative skills critical to their success.

Case Studies
Presented by agents, investigators, and prosecutors, these case studies will explore all phases of the investigation and will highlight investigative strategies and skills.

Data Analytics
Through case studies or scheme development, faculty will explore analytical methodologies that can uncover leads and fraud schemes, help to launch new investigations, support investigators on existing cases, and share best practices to maximize their investigative impact.

Case Discussion Roundtable Meetings

Case Discussion Roundtable Meetings are small group discussions where private insurer members experience the value of collaboration. Public and law enforcement partners share case information and discuss schemes, trends, and fraud patterns.

Eligible Attendees are required to participate. Participants must be an employee of a NHCAA Member Organization, Law Enforcement Liaison, or Affiliate Member to attend.



The NHCAA Institute is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website:

Target Audience: This program is most appropriate for mid to senior-level analysts, investigators, consultants, and law enforcement agents working in the health care anti-fraud industry. However, anyone with at least two years working in the health care anti-fraud industry would benefit from the material presented at this program.

Level: As a level II, or intermediate program, some investigative / health care / coding expertise is assumed.

Pre-requisites: Two years working in the health-care anti-fraud industry or attendance at the Boot Camp Program.

Member1 Government2 Non-Member3
$1,125 $1,350 $1,600

Register online via secure transactions. Please have a Visa, MasterCard, Discover or American Express card available


Fill out & print completed registration form.

Registration Policy

Registration Deadline: May 29, 2020
NHCAA accepts registrations after this date; however, NHCAA may not be able to include your contact information in the participant roster or have a certificate of completion on-site for you.

All cancellations (regardless of date) will be assessed with at $100.00 administrative fee.

  • All written notice of cancellations and substitutions should be sent via email to
  • Before cut-off date - To cancel and obtain a full refund (minus an administrative fee) or to request a substitution, you must provide written notice to The NHCAA Institute - NETS.
  • After cut-off date - If you cancel in writing after the cut-off date, no refund will be provided but credit for future training is available. All substitution requests received after the cut-off date will be charged a $100.00 administrative fee.

For more information regarding administrative policies on refunds and cancellations or to register a complaint, please contact

1NHCAA Member rate applies to all NHCAA Member Organizations, Affiliate Members, Individual Members, Platinum 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.
3Non-Member participants must occupy a professional position with a private for-profit or not-for-profit health care reimbursement organization, or in a local, state or federal law enforcement, prosecutorial, or 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:

Westin San Diego Gaslamp Quarter
910 Broadway Circle
San Diego, California 92101

Westin SanDiego

Hotel Information



Hotel Cut-off: May 25, 2020

All rooms are sold first come, first served. Rooms may sell out prior to the cut-off date, so book at your earliest convenience.

Participants should identify themselves as being with the NHCAA National Education & Training Series (NETS). If you are a federal employee and qualify for the government rate, please also identify yourself as qualifying for the government block.

Room Rates

Standard Single: $219*
Government Single: $173*

*Cost does not include a 15% in state and local taxes.

Cancellation required by 4pm at least 5 days prior to arrival to avoid a charge of one night's room and tax. All reservations are required to be guaranteed with a valid credit card. Please be advised that five days prior to your arrival, an authorization equivalent to a one night's room and tax charge will be processed on your card. Authorizations on a debit card will place a hold on funds within your bank account at the time of authorization.

Check-in: 3:00 pm
Check-out: 12:00 pm

Travel Information

San Diego International Airport (SAN)

*IMPORTANT: Website URLs, taxi fares, parking costs, check-in & check-out times, and other quoted prices and information may be changed at the vendors' discretion. Please confirm all costs associated with your travel prior to attending the program.