Ohio Dept. Focuses on Health Care Fraud April 14

April 8, 2005

The Ohio Department of Insurance will host a daylong health care fraud seminar Thursday, April 14 at the Confluence Park Restaurant in Columbus.

Insurance Director Ann Womer Benjamin will welcome guests at 9 a.m. and the seminar will continue with presentations about overcoming common health care fraud legal defenses, problem billing codes, new fraud fighting software and suggestions to help investigators best prepare and try health care fraud cases. The seminar will conclude at 3 p.m. after a regulatory and industry roundtable discussion.

One of the Department’s top priorities in 2005 is reportedly to continue to improve its capacity to handle investigations of fraud and misconduct. The Department works with law enforcement, insurers and consumers to identity and pursue fraud.

Seminar itinerary:

9 a.m. – Welcome: Insurance Director Ann Womer Benjamin

9:15 a.m. – Overcoming Common Legal Defenses: William Michael Jr., Esq., Lindquist & Vennum PLLP, will discuss common defenses in complex health care fraud investigation, and potential strategies that can be implemented to counter these defense

10:30 a.m. – Problem Billing Codes: Robert Poteete, D.C., Chiropractic Health Center, will discuss current procedural terminology (CPT) codes and modifiers that are often misrepresented. Current billing patters will be reviewed utilizing actual cases. Participants will learn how these current problem codes apply to fraud and abuse.

11:30 a.m. – Lunch (provided)

12:30 p.m. – Fraud Fighting Software: Cynthia Lucas, Anthem, BCBS, will discuss new computer software that aids in detecting false health care claims.

1 p.m. – Organizing Your Health Care Fraud Case: Barbera Tanase and Kathy Brooks, U.S. Attorney’s Office, Western District of Michigan, will provide agents and investigators with suggestions for preparing a health care fraud case from the initial complaint through trial.

2 p.m. – Break

2:15 p.m. – Roundtable Panel Discussion

3 p.m. – Conclusion

A seminar brochure is available on the Department Web site at www.ohioinsurance.gov.

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