2015 Annual Training Conference & Anti-Fraud Expo

Sessions Speakers Exhibitors Show Specials Floor Plan Buzz

Clinical Laboratory Case Study (Room Seaport H)

The presenters will discuss schemes used to defraud Medicare and private insurances in the area of clinical laboratories and ways to investigate and prosecute those schemes. Discussions will involve ways that CPT Codes are manipulated and means to conceal bribe and kickback payments. There are many methods which can be used to investigate clinical laboratory frauds and bribes/kickbacks and the presenters will explain some of the successful tactics they have used. During the presentation, a current investigation will be used as a case study to discuss the detection of fraudulent activities, ways to identify practitioners and clinical laboratories involved in fraud and bribes/kickbacks, the use of claims pattern analysis and financial record review, and the use of law enforcement techniques. Attendees will receive information that can improve their investigative skills and increase the rate of success when investigating and prosecuting clinical laboratory cases.