Day 1 - Sunday 24 March, 2019
Opening Session
Session One
The Basics of Forensic Interviewing
- Planning the interview
- Who to interview first
- What to ask and how to ask it
- Building a case
- Understanding the relationships; who are our potential bad actors
Morning Break & Networking
Session Two
The Basics of Forensic Interviewing
- Who could have culpability
- Body language and detection of deception
- Finding common ground
- Dealing with angry or reluctant interviewees
Lunch Break & Networking
Session Three
Examples and Round Table Discussions
- Reviewing examples
- Open discussion of experiences and successes
- Actual interviews within the group
Evening Break & Networking
Session Four
Examples and Round Table Discussions
- The theory and application of interviewing principles
- The processes and procedures in building a case
Day 2 - Monday 25 March, 2019
Session One
Behavioral Analytics
- Evaluating and measuring the results of interviews
- Where to go next?
- How does a fraudster think?
- Where does the fraud triangle fit?
Morning Break & Networking
Session Two
Behavioral Analytics
- The power of emotions and when honesty reverses course
- Accusations?
- Disclosing key pieces of information
- Various techniques to employ as needed depending on how the interview goes
Lunch Break & Networking
Session Three
Legal Issues In Healthcare Fraud Investigations, Example Cases Using Varied Provider Types, Laws Surrounding Healthcare Fraud And Abuse
- Where do the legal issues start and finish in an investigation?
- How do we know when to call the lawyers?
- What if they request counsel?
- What rights does a fraudster have?
Evening Break & Networking
Session Four
Legal Issues in Healthcare Fraud Investigations, Example Cases Using Varied Provider Types, Laws Surrounding Healthcare Fraud And Abuse
- Group review of key cases involving
- Psych Services
- Critical Access Hospitals
- “Consulting Services”
- Dental Services through Medicaid
- Radiation Oncology
- Transportation
- False Claims Act Specifics
- Ant kickback Related to Specific Fraud Case
- Application of laws in unusual ways
- Group discussion and Q&A