2015 Annual Training Conference & Anti-Fraud Expo

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An Ambulance Fraud Case Study (Room Coronado A)

18 Nov 15

11:00 AM - 12:00 PM

Tracks: Fraud in Medicaid Program, Law Enforcement Path

Speaker(s): Michael Wysocki, CPA, Senior Investigator, Anthem, Inc.; Stormy Kelly, Director, Medicaid Fraud Control Unit of Texas, OAG

The presentation will focus on a multifaceted investigation involving ambulance service providers and habilitation therapy centers. Investigators uncovered the scheme where 40 ambulance companies in the Houston Texas area that were transporting Medicaid recipients to group habilitation therapy in transportation vans but billing for ambulance transportation. The case study will focus on the investigative techniques used to uncover the scheme and how to identify these patterns in your claims data.

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