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					Texas Department of Insurance 11th Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS
February 2-4, 2009  Austin, Texas  Commons Conference Center

INTRODUCTION AND WELCOME February 2, 2009 12:00– 12:15

Synopsis th Welcoming address for the 11 Annual Texas Department of Insurance Fraud Conference. Biography Governor Rick Perry appointed Mike Geeslin as Texas Insurance Commissioner effective June 7, 2005. The Commissioner of Insurance is the chief executive of the Texas Department of Insurance (TDI), which employs over 1,600 personnel and regulates a $99 billion market. During his tenure, the agency has seen a number of transitions, challenges and milestones: The 2005 merger of the Texas Workers’ Compensation Commission with TDI; major enforcement actions for a number of lines of insurance; improved efficiency through better use of technology; Hurricanes Rita (2005), Dolly and Ike (2008); economic cycles involving major market disruptions; a successful Sunset review of the Agency; establishing a set of core values and more refined strategic planning process to guide agency leadership; and, the creation of TDI Academy, an initiative that will bring together industry and higher education to build a better and more diverse pool of insurance leadership talent for the state. Before being appointed Commissioner, Geeslin served as the Department’s Deputy Commissioner for Policy from January 2003 to the time of his appointment as Commissioner of Insurance. Prior to his service at TDI, Geeslin served as budget and policy advisor on insurance and regulatory matters to Governor Perry at the Governor’s Office and previously at the Lieutenant Governor's Office. He also worked as chief of staff for the late state Senator Tom Haywood, as a legislative aide to state Senator Florence Shapiro, and as an assistant to U.S. Congressman Joe Barton. Along with his regular duties at the Insurance Department, Geeslin is a member of the International Association of Insurance Supervisors Core Principles Task Force, a past Fellow of the Center for Public Policy Dispute Resolution, and a member of the NAIC’s Government Relations Leadership Council. Commissioner Geeslin is a 1991 graduate of Texas A&M University, where he currently serves on the Communications Department Alumni Advisory Board. He and his wife, Danica Milios-Geeslin, live in Austin and have three children, and are involved with volunteer projects in Cub Scouts, soccer and school activities. Contact Information Mike Geeslin Texas Department of Insurance P.O. Box 149104 Austin, TX 78714-9104 512-463-6464

Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Synopsis Several trends are developing as a result of the declining economy and the pressures that consumers and insurers are facing. Organized criminal rings also seem to be seizing the opportunity in focusing on a variety of fraud scams. Speaker will discuss research on how the fraud-fighting community, especially state fraud bureaus and insurers, are addressing various scams. Some state legislatures also are responding with creative proposals to give fraud-fighters new tools to combat increasing fraud schemes. Consumer groups and anti-fraud organizations also are stepping up public-outreach programs to help consumers avoid becoming victims of fraud and to increase deterrence efforts. Biography Dennis Jay is executive director of the Coalition Against Insurance Fraud. He has served as chief executive officer since the coalition's founding in 1993. He oversees the coalition's three main areas: government affairs, public outreach and research. Dennis coordinated drafting of a comprehensive model insurance fraud law, which 19 states have passed wholly or partly. In 1996, Dennis initiated breakthrough research on why Americans do and don't tolerate insurance fraud, which was conducted again in 2007. He is a frequent speaker on insurance fraud, and has testified before state and federal legislatures. He currently serves on the advisory board to the fraud bureau within the Virginia State Police, and in 2007 he was appointed to a state blue ribbon panel to recommend ways to strengthen anti-fraud efforts in California. Former Maine Gov. Angus King also appointed Dennis to a commission studying insurance fraud and recommending reforms to the legislature, which resulted in passage of a comprehensive insurance fraud statute. In 2000 he initiated the chartering of the New York Alliance Against Insurance Fraud, and now serves on the alliance's board. NYAAIF has raised nearly $3 million to help educate consumers about the fraud issue and how it affects them. He also is advisor to the board of directors of the International Association of Special Investigation Units, and serves as a guest lecturer at the FBI Academy’s in-service training on white-collar crime. Dennis is a sought-after news source for the media, and is widely quoted in newspapers, magazines and on television. He has authored dozens of articles and reports on insurance fraud, and currently writes Insurance FraudBlog, a popular Internet weblog on issues and analysis of current fraud topics. He’s a frequent public speaker on fraud issues in the U.S, and internationally, including in Europe, South America, Australia, New Zealand and Canada.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biography, continued In 2003, Fraud International magazine named him “Fraud Fighter of the Year” for his efforts in leading anti-fraud initiatives during the first ten years of the coalition’s existence. The website named Dennis one of the 100 most powerful people in the insurance industry. He formerly served as vice president of communications for the National Association of Professional Insurance Agents, where he developed joint industry-consumer coalitions and worked in consumer affairs, public relations and publishing. He holds a BA in business administration. Contact Information Dennis Jay Coalition Against Insurance Fraud th 1012 14 St., N.W. , Suite 200 Washington D.C. 21403 202-303-7333

ADJUSTER FRAUD CASE STUDY February 2, 2009 1:20 – 3:00

Synopsis The case study centers on a Hartford Claims Handler that sought out and succeeded at finding methods to defraud her employer of $1.7 million dollars in less than six months. With the help of friends and family she created a network of fraudulent entities (primarily Chiropractic facilities) and claims. She and her friends were long suspected of staged accident fraud in the Houston, TX area. One small fatal mistake by the Handler led to Investigative Services conducting a large scale investigation that resulted in Federal Criminal charges against the Handler and four of her accomplices. The Handler and one defendant pled guilty, three went to trial and lost. Sentencing of all defendants is expected to be completed by January 2009. Biography Director, Department of Investigative Services, Internal Audit, responsible for managing national and international investigations involving misconduct on the part of employees, vendors, agents and brokers of The Hartford. Management of The Hartford’s Background Unit. Provides training on fraud and Code of Conduct issues to Hartford employees. Former Captain, Connecticut State Police; served twenty-five years in positions of increasing responsibility with broad experience in operational planning, management and supervision of law enforcement coordination of emergency response, intelligence, formulation of policies and procedures, public relations, budget control, tactical response, and disturbance control. Former Director of Security and Investigative Operations for a large company utilizing stateof-the-art techniques and equipment in all investigation functions for private and public section clients nationwide and abroad. Graduate of the FBI National Academy; additional special training through the U.S. Federal Prison System,- U.S. Treasury Department, Connecticut State Police, Chief State Attorneys Office, International 'Association of Chiefs of Police, California Department of Justice, International Association of Bomb Technicians, and others.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biography, continued Education: B.S. Criminal Justice Administration, University of New Haven; Law Enforcement Management Command Training Center; Babson College, Wellesley, Massachusetts Contact Information Robert O'Shaughnessy The Hartford - Investigative Services Hartford Plaza Hartford, CT 06115 860-547-6297


Synopsis The presenters will define the types of insurance fraud and list the elements that must be met to prosecute each type of insurance fraud. Additionally, the presenters will discuss the evidence necessary for the prosecution of insurance fraud. Also, there will be description of challenges that prosecutors encounter during the insurance fraud trial and recommend techniques for overcoming juror biases. Biographies Kyson Johnson is the first full-time insurance fraud prosecutor employed by the Texas Department of Insurance (TDI). The position is part of a cooperative agreement between the Dallas County District Attorney’s office and TDI to combat the ever-increasing problem of insurance fraud. Kyson is responsible for prosecuting all cases of insurance fraud that occur in Dallas County. Cases prosecuted cover all aspects of insurance fraud from claimant & provider fraud to insurer fraud and include the entire range of felony offenses. Kyson has presented seminars on combating insurance fraud at the Texas Workers’ Comp Forum, National Insurance Crime Bureau (NICB) SIU seminar, Texas Department of Insurance Annual Fraud Conference, Texas Association of Life and Health Insurers, National Association of Special Investigative Units, Certified Fraud Examiners Association, and the American Council of Life Insurers national compliance section meeting as well as other organizations. Kyson was named the Prosecutor of the Year by a Texas Advisory Council on Arson in 2008 for his efforts fighting Arson and Insurance Fraud. Before joining TDI Kyson was an assistant district attorney for Grayson County, Texas. In Grayson County Kyson served as lead counsel for the prosecution and disposition of all th felony level cases assigned to the 59 District Court. In addition to his civilian job, Kyson is also a Captain in the United States Army Reserve where he serves as a Judge Advocate. Kyson was activated by the U.S. Army from February 2003 to August 2004. While activated Kyson served at Fort Hood, Texas and deployed to Iraq in support of OPERATION IRAQI FREEDOM. Kyson served in detention operations at the Abu Ghraib prison where he was a magistrate and reviewed over 1500 detainee files to determine legal status of detainees, potential cases for prosecution, and assess sentences for minor criminal offenses. Kyson also served as Special Prosecutor for the Abu Ghraib prison abuse cases and co-prosecuted the first prison abuse special courtmartial, United States v. SPC Jeremy Sivits, conducted in Baghdad, Iraq.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biographies, continued Kyson attended Texas Wesleyan University School of Law graduating with a Juris Doctorate, Cum Laude, in 1995. He also received the American Jurisprudence Award for Civil Procedure in 1993 and was an Associate Editor for the Texas Wesleyan Law Review from 1994-95. Professional Associations Member, Texas District & County Attorneys Association 2001-present Vice-President, Grayson County Young Lawyers Association 2002-2003 Director - Dallas Trial Lawyers Association 2000-2002 Director - Texas Trial Lawyers (Advocates Division) 1998-1999 Co-Chair - Solo & Small Firm Committee, Dallas Assoc. Young Lawyers 1999 Member, DAYL Special Olympics Committee, 1995 - 1998 Member, Dallas Bar Juvenile Justice Committee 1998-2001 Member, DAYL Legal Aid to Elderly Committee, 1996-1997 Member, Dallas Association of Young Lawyers 1995-2001 Member, State Bar of Texas 1995-present Craig McNeil serves as a special prosecutor for the Texas Department of Insurance's Fraud Unit and as a special assistant district attorney in Dallas, Texas. Craig also holds the rank of major in the United States Army Reserve. Craig is a graduate of Fort Worth's Southwest High School, New Mexico Military Institute, Texas Christian University, and Baylor University's School of Law. Following service as a Regular Army military lawyer in Germany and Kosovo, Craig practiced law in Burleson, Texas with Burleson Mayor Ken Shetter until he was recalled to active Army service in early 2003. During his service in Iraq with his friend and fellow Army Reserve officer, Captain Kyson Johnson, Craig had the dubious distinction of serving as the legal advisor to the commander of Abu Ghraib Prison when the abuses there became widely known to the public. In this role, Craig participated in the successful prosecution of one of the Soldiers responsible for abusing Iraqi detainees. For his overall service in Iraq, Craig received the Bronze Star Medal and the Army's Combat Action Badge. Craig has over twenty years of combined military service in the Texas Army National Guard, the Regular Army, and the Army Reserve. His military assignments have taken him to West Texas as a Counterdrug Unit officer in charge, Germany, Kosovo, Iraq, and Honduras. As a writer, Craig contributed essays to the Village Voice and he has also been featured in interviews by the Fort Worth Star-Telegram and NPR. Craig recently completed a two-year military mobilization at Fort Bragg, North Carolina as the deputy chief and as a prosecutor in the capital murder section of the Office of the Staff Judge Advocate for the Eighteenth Airborne Corps. Contact Information Kyson Johnson or Craig McNeil Specialized Crime Division, Dallas County DA’s Office Frank Crowley Courts Building 133 N. Industrial Boulevard, L.B. 19 Dallas, Texas 75207-4399 214-653-3664

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS

CHIROPRACTIC FRAUD February 3, 2009 8:00 – 10:00

Synopsis An A to Z explanation of chiropractic, practice and a frank discussion of chiropractic problems. Coding and guidelines will be discussed. Potential chiropractic fraud areas. Biography Dr. Bill Timberlake has practiced chiropractic in Dallas for over 44 years. He was active in the professional associations in Texas and nationally for many years. He is past president of the Texas Chiropractic Association, was instrumental in forming the Texas Insurance Chiropractic Joint Advisory Commission (TIC/JAC), served on the Texas Peer Review Executive Committee for eight years and was Department Head of External Affairs for the TCA. Nationally, he was Chairman for the ACA Insurance Commission in the 80’s and is a Fellow in the International College of Chiropractors since 1976. He is owner and chairman of Chiro Claims Plus, Inc., and has served as Chairman of the Texas Healthcare Anti-fraud Association, and was the Medicare consultant for Texas for 36 years. He has been given many awards in chiropractic. He was the only named chiropractic expert for the prosecution in the Allstate vs. Accident & Injury, et al, federal case. Contact Information Bill W. Timberlake, D.C., F.I.C.C. 3016 N Jim Miller Road Dallas, TX 75227 214-381-1481

RESIDENTIAL ARSON & K9 DEMO February 3, 2009 8:00 – 10:00

Synopsis The presentation will pertain to the building/habitation arson investigations. The presenter will have a case study on an arson of a habitation where the owners were suspected of insurance fraud. The presentation will also cover an overview of "red flags" in building/habitation fires that may lead an investigator to determine that the building/habitation was intentionally set on fire. Also, avenues an investigator can perform if suspecting insurance fraud. Additionally, the canine team will do a demonstration with the following objectives.  Understanding the K-9 Team  Understanding how the K-9 Team works  Knowing what a K-9 Team can do for you  Knowing when to call a K-9 Team  Knowing what to do before and after calling a K-9 Team

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biography Chris Janssen is a certified basic fire and arson investigator employed with the Texas State Fire Marshal’s Office as a Deputy Marshal, assigned to the Fire/ Arson Investigation Division for over eight years. As a criminal investigator, Mr. Janssen has over thirteen years of experience. Mr. Janssen has assisted local, state, and federal authorities with investigations throughout the State of Texas. These investigations have produced convictions that have confined offenders in both state and federal penitentiaries. Mr. Janssen has testified in State Courts as an expert witness in cases of arson. Mr. Janssen graduated in 1992 from Wharton County Junior College with Associates of Arts Degree. He is currently attending Texas A&M University – Corpus Christi. Mr. Janssen has receive numerous formal and specialized training, including the most recent training in 2007 for Scene Search and Evidence Recovery, Fatality Fire Investigation, Forensic Fire Reconstruction, Introduction to Fire Dynamics and Modeling, and Fire Dynamics Calculations. Mr. Janssen has also conducted several trainings, which include Origin and Cause Investigation for First Responders, Arson Investigation, and Arson Evidence Collection. Tommy Hubertus has been an investigator with the State Fire Marshal’s Office (SFMO) for over eight years. Hubertus has worked as a canine handler for four of those years. He covers central and south west Texas. In addition to his work with SFMO, Hubertus is a Police and Fire Instructor Contact Information Chris Janssen Texas State Fire Marshal's Office 301 North Live Oak Rockport, TX 78382 361-729-2222 Tommy Hubertus Texas State Fire Marshal's Office 7910 Cameron Rd. Austin, TX 78754-3803 512-417-7227

AUTO BLACK BOX TECHNOLOGY February 3, 2009 10:15 – 12:00

Synopsis The speaker will explain “black box” technology, the types of data that can be extracted, and how the information can be used. Biography Scott Palmer is the CEO of Injury Sciences LLC, a forensic technology company. Injury Sciences is the leading provider of science-based auto claim evaluation technologies which assist in the identification and proactive resistance of fraudulent injury claims.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biography, continued Scott is also an architect of claim technologies and solutions that facilitate the use of “black box” information in the evaluation of auto claims. He has served as an expert resource to state legislators in their evaluation regulations regarding the access and use of “black box” technology. Scott has also been actively involved in low velocity collision and soft tissue injury research over the last ten years and has been as a test subject in over a half-dozen low velocity collision experiments that have been published. Prior to founding Injury Sciences, Scott was the President and CEO of Biodynamic Research Corporation in San Antonio, TX, an internationally recognized firm in the field of impact biomechanics. Scott earned a Bachelor of Science from Louisiana Tech University in 1980 and an MBA from the University of Alabama in 1982. Contact Information Scott Palmer Injury Sciences, LLC 301 E Ramsey San Antonio TX 78216 877-979-7378


Synopsis The National Insurance Crime Bureau is the nation's premier not-for-profit organization dedicated exclusively to fighting insurance fraud and crimes that cost the insurance industry billions of dollars annually. Currently, approximately 1,000 property and casualty insurance companies and self-insured organizations compose the NICB's membership. Today, insurance fraud and crimes are complex and sophisticated, and dominated by organized rings and multi-national criminal enterprises. To address these problems, the NICB deploys specialized solutions utilizing highly advanced information technology coupled with professional crime-fighting expertise. Through its five disciplines (Data Analytics, Investigations, Training, Legislative Advocacy and Public Awareness), the NICB helps its members, the insurance industry, law enforcement and the American public recognize the threats posed by insurance criminals, and provides guidance on how to protect assets and prevent losses. We must take action and lead a united front to better combat these crimes. Biography Joseph H. Wehrle, Jr., serves as President and Chief Executive Officer for NICB. From 2003 – 2007, Mr. Wehrle was Senior Vice President, then President of USAA Property and Casualty Insurance Group. As President of USAA, Mr. Wehrle led nearly 11,000 employees located in six national and two international locations catering to over five million members. He had overall responsibility for an $8 billion book of business, which experienced record growth for auto, property and homeowners insurance during his tenure.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS PERSPECTIVES ON INSURANCE FRAUD AND CRIME, continued Biography, continued Mr. Wehrle completed a distinguished 33-year career in the United States Air Force having risen to the rank of lieutenant general. He served in various leadership positions with the U.S. Air Force and retired in 2003 as the Air Force Assistant Vice Chief of Staff. Mr. Wehrle holds a Bachelor of Science degree in engineering from the U.S. Military Academy, West Point, New York (1970), and a Masters Degree in business administration and management from the University of Utah, Salt Lake City, Utah (1979). He is also a graduate of the Air Force Air Command and Staff College (1983) and the National War College (1987). Contact Information Joseph Wehrle National Insurance Crime Bureau 1111 E. Touhy Avenue, Suite 400 Des Plaines, IL 60018 (800) 447-6282 (ext. 7050)

PRESENTING CASES FOR PROSECUTION February 3, 2009 1:30 – 3:00

Synopsis An overview of issues involved in presenting cases for prosecution. Biography Lester Blizzard is an Assistant District Attorney with the Harris County. He has worked at the Harris County District Attorney’s Office since 1989 and has served in all areas of the office. Mr. Blizzard hold a J.D. from South Texas Law and a M.B.A. from Texas Women's University. Mr. Blizzard’s certifications include:    Board Certified in Criminal Law - State Bar of Texas Certified Fraud Specialist - Asso. of Fraud Specialist Certified Texas Peace Officer - TCLOSE

Contact Information Lester Blizzard Harris County District Attorney's Office 1201 Franklin Suite 600 Houston, TX 77002 713-755-6916

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Synopsis The presentation will provide instruction on how the Louisiana State Police conduct fraud investigations in a post catastrophe environment. The instructor will discuss case studies and practices implemented after Louisiana was devastated by Hurricanes Katrina and Rita in 2005. The lessons learn provide a template for fraud investigations after any catastrophe. Biography Lieutenant Carpenter currently serves as the Criminal Program Coordinator for the Louisiana State Police Criminal Investigation Division. From 2004 to 2008 he supervised the Louisiana State Police Insurance Fraud / Auto Theft Unit, which consisted of six field offices around the state that housed a total of twenty-seven commissioned investigators and two support staff; as well as two investigators and a clerk that perform Cooperative Disability Investigations for the Social Security Administration. Lt. Carpenter has served with the Louisiana State Police for the past 19 years. For the last 13 years, he has been assigned to the Criminal Investigation Division and has been assigned to the Insurance Fraud Unit since its inception in 1999. Lt. Carpenter has an Associate’s Degree in Criminal Justice from Nicholls State University and a Bachelor’s Degree in Criminology from Louisiana State University. In addition to his formal education, he has over 1000 hours of criminal investigative instruction. Lt. Carpenter has been recognized and/or awarded as State Law Officer of the Year for the Middle District of Louisiana (2001); Emergency Services Award (2002 and 2003); a Unit Citation for Outstanding Achievement in the Insurance Fraud Unit (2004); I.A.S.I.U. Louisiana Chapter “Fraud-Buster” Award (2004); a Meritorious Service Award (2005) and the I.A.S.I.U. National Public Service Award (2005). In 2005, Lt. Carpenter was appointed to the Board of Directors of the Louisiana Auto Theft and Insurance Fraud Prevention Authority. Additionally, Lt. Carpenter serves as a member of the Executive Committee for the Board of Directors of the Coalition Against Insurance nd Fraud. In 2008, He was appointed as the 2 Alternate for the South Central Region on the Board of Directors of the National White Collar Crime Center (NW3C). Contact Information Allen Carpenter Louisiana State Police 7919 Independence Blvd., Box A-19 Baton Rouge, LA 70806 225-925-3701


Synopsis Presenters, experienced in these individual areas of workers compensation fraud, will explain WC Fraud investigations from "referral to the fraud finding" and subsequently "building the fraud case for prosecution." Specific cases that have resulted in successful prosecution will be the primary subject matter as the presenters walk the participants through the case findings, collection of criminal evidence and presentation to the prosecutor. While cases are generally derived from reactive sources, the presenters will address proactive queries to identify possible fraudulent indicators. The presenters will provide illustrations of case building as well as video, investigative resources and other forms of evidence used to develop the fraud case. Time will be provided for questions and answers.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biography Eileen Cook Supervisor, Claimant Fraud Unit Cook completed her Bachelor of Science in Criminal Justice at the University of Houston at Clear Lake City. She served as an investigator for the Brazoria and Midland County Sheriff’s Departments for a total of 12 years. After leaving law enforcement, Cook served as a training specialist at Southwest Texas State University’s “Institute of Criminal Justice Studies” training both police and probation officers for ten years. Cook began her work at Texas Mutual Insurance Company as a Claimant Fraud Investigator in 1995 and served in that capacity for 11 years before her current position as Supervisor of the Claimant Fraud Unit for the past two years. Kathleen Haden Team Leader Haden completed her Bachelor of Arts in Writing, Literature and Publishing at Emerson College in 1995 and obtained her Paralegal Certificate from Northeastern University in 1997. She worked for Rosenfeld & Associates in Boston, Massachusetts, for three years, focusing primarily on health care law. She then went to work for Texas Mutual Insurance Company as a Legal Assistant in 1999. In 2004, she was promoted to Investigator II within the Special Investigations Department and currently holds the position of Team Leader. She also serves as the subject matter expert for the Office of the General Counsel on company medical billing systems and data mining. Grace Nicholas Supervisor, Premium Fraud Unit Nicholas completed her Bachelor of Business Administration in Accounting at Southwest Texas State University in 1988. She worked for the Texas Department of Insurance for 5 years as an Examiner, Reinsurance Examiner and Fraud Investigator. She then went to work for Texas Mutual Insurance Company as an Investigator in 1993. In her 15 years with Texas Mutual Insurance Company, she has been promoted to various positions within the Special Investigations Department and currently holds the position of Supervisor of the Premium Fraud Unit. Her unit investigates policyholders and insurance agents that manipulate the system in order to obtain lower premiums that are unjustified. She has given numerous depositions in civil cases, testified in civil court and before Texas grand juries on matters involving Texas Mutual Insurance Company. Contact Information Eileen Cook, Grace Nicholas and Kathleen Haden Texas Mutual Insurance - Special Investigations 6210 East Highway 290 Austin, TX 78723-1098 Eileen: 512-224-7380, Grace: 512-224-3866, Kathleen: 512-224-3317,,

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS

FRAUD UNIT UPDATE February 4, 2009 8:00 – 8:30

Synopsis The presentation will look back at fiscal year 2008 and the accomplishments through our collected effort to fight against insurance fraud in Texas. Mr. Pompa will also present a brief look into steps towards enhancing fraud reporting in fiscal year 2009. Biography Dennis Pompa is the Associate Commissioner and Director of the Texas Department of Insurance Fraud Unit. He was promoted to this position in September, 2003, by the Texas Insurance Commissioner. Prior to his promotion Dennis was the Deputy Commissioner and Chief Investigator for the Fraud Unit. He has worked in the Fraud Unit since it became a law enforcement agency in 1995. Prior to coming to the Texas Department of Insurance, Dennis was employed as a bank executive; police officer and district attorney financial crimes investigator. His career as an insurance fraud investigator spans almost two decades. Dennis holds a Bachelor of Science degree in Criminal Justice Administration; is a Certified Fraud Examiner (CFE) and also maintains a Texas Master Peace Officer certification. Dennis is currently the TDI Fraud Unit liaison for law enforcement agencies and antifraud organizations. Contact Information Dennis Pompa Texas Department of Insurance Fraud Unit P.O. Box 149336 Mail Code 109-3A Austin, Texas 78714-9336 512-463-6492

TDI FRAUD INVESTIGATION PROCESS February 4, 2009 8:35 – 10:00

Synopsis Presentation will provide the SIU with information on filing a suspected fraud report to the Texas Department of Insurance Fraud Unit. Information will be provided on the Fraud Unit Intake process and the initial review of complaints received. In addition, the presenters will outline what the complainant needs to provide the Fraud Unit for a fair assessment of the complaint in order to be opened as an investigation. Biographies Captain Bobby Beck came to the Fraud Unit in May 2005 as an investigator working Insurer Fraud investigations. He was promoted to Captain in December 2006 and currently supervisor investigators assigned criminal cases associated with claimant fraud and workers’ compensation. Captain Beck retired from the Houston Police Department as a Lieutenant in 1992 after 21 years of service. From 1996 to 2005 conducted fraud investigations at the Texas Lottery Commission.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Biographies, continued Captain Jeff Kirk started his career with the Galveston County Sheriff’s Department. Jeff joined the Friendswood Police Department in 1999 as a patrol officer and was assigned to the SWAT team. Jeff was promoted to detective in the departments Criminal Investigation Division, where he was tasked with investigating a variety of cases, including property crimes, crimes against persons, and white collar financial crimes. Jeff joined the TDI Fraud Unit in 2006as an Insurer Fraud investigator. Jeff was promoted to his current supervisory position in 2007, overseeing the division’s Insurer Fraud and Mortgage Fraud teams. Jeff holds a Bachelor of Science degree in Criminal Justice from the University of HoustonDowntown, and a Texas Master Peace Officer certification. Captain Jack Hall is the manager of the Fraud Unit's Operations and Training Section, which includes the Intake Section. Prior to his current assignment, he was the Section Chief for the Insurer Fraud Team. Jack is a veteran peace officer with extensive investigative experience ranging from assignments in organized crime, narcotics, intelligence and others. He is also a graduate of the FBI National Academy, the Law Enforcement Management Institute of Texas and holds a Bachelor of Science degree in Criminal Justice. Hall has been with the Fraud Unit for approximately five years. Contact Information Bobby Beck, Jeff Kirk & Jack Hall Texas Department of Insurance – Fraud Unit P.O. Box 149336 Mail Code 109-3A Austin, Texas 78714-9336 512-463-6492

MORTGAGE FRAUD February 4, 2009 8:35 – 10:00

Synopsis This presentation will cover the following general topics: a.) what Mortgage Fraud is; b.) how Mortgage Fraud is committed; c.) what criminal statutes can be utilized to prosecute Mortgage Fraud; d.) how Mortgage fraud is investigated by the Special Crimes Division of the Collin County District Attorney's Office; and e.) how Mortgage Fraud is prosecuted by the Special Crimes Division of the Collin County District Attorney's Office. Time permitting; there should be some time for follow-up questions and answers. Biography Christopher Lee Milner, Chief, received an undergraduate degree in Mathematics from Rice University in Houston, Texas, in 1972, and his Doctor of Jurisprudence degree from the University of Texas in Austin, Texas, in 1976. He served as an Assistant District Attorney in the Criminal Division of the Dallas County District Attorney’s Office, an Assistant U.S. Attorney in the Criminal Division of the U.S. Attorney’s Office for the Northern District of Texas, and a Supervisory Assistant U.S. Attorney in the Criminal Division of the U.S. Attorney’s Office for the Southern District of Texas, joined the White Collar Section of the Dallas law firm of Gardere & Wynne in 1989, and established a solo defense practice in 1991. Mr. Milner is Board Certified in Criminal Law by the Texas Board of Legal Specialization, and is licensed to practice in all Texas Courts, the U.S. District Courts for the Northern, Southern, Eastern, and Western Districts of Texas, the U.S. Court of Appeals for the Fifth Circuit, the U.S. Tax Court, and the U.S. Supreme Court. He returned to the prosecution in May 2003, joining the Collin County Criminal District Attorney’s Office as Chief of the Special Crimes Division.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Contact Information Christopher Milner Colin County District Attorney’s Office 2100 Bloomdale Road, Suite 20004 McKinney, TX 75071 972-548-4323

HEALTH CARE FRAUD CASE STUDY February 4, 2009 10:15 – 12:00

Synopsis Discussion of issues that are keys to success in a criminal insurance fraud case. Biography Sam Louis graduated from Thurgood Marshall School of Law in 1989 with honors. After law school, Louis worked for Shell Oil Company in Houston, Texas as a landman reviewing oil and gas leases from July 1989 to January 1990. Louis then joined the Orange County District Attorney’s Office in Orange Texas as an Assistant District Attorney prosecuting all types of state criminal violations. Louis also represented Orange County in civil suits filed against the county. In September 1992, Louis joined the United States Attorneys Office for the Southern District of Texas as an Assistant United States Attorney. The United States Attorneys Office for the Southern District of Texas is a component of the United States Department of Justice. During his 16 plus years as a Assistant United States Attorney, Louis has been involved in the prosecution of all types of federal criminal violations, including, immigration, gun offenses, bank robbery, bank fraud, organized drug trafficking, extortion, income tax violations to name a few. He is currently the Health Care Fraud Coordinator for the Southern District of Texas and since 2000, has spearheaded the prosecution of Health Care Fraud violations including the manufacture, importation/exportation and distribution of counterfeit pharmaceutical drugs. Louis has traveled internationally concerning the investigation and prosecution of individuals committing Intellectual Property Rights violations, including places such as China, Peru, Columbia, the United Kingdom, Tanzania and South Africa. Most recently Louis has been involved in a case that has resulted in the first extradition of a foreign national for Intellectual Property Rights violations regarding the importation and distribution of counterfeit pharmaceuticals. Louis has participated in many seminars sponsored by state and federal agencies, as well as private enterprises dealing with the issue of health care fraud. Louis has also prosecuted many health care providers, including doctors and owners of medical facilities who have been involved in defrauding Medicare and private insurance companies. Contact Information Sam Louis U.S. Attorney's Office Southern District of Texas P.O. Box 61129 Houston, TX 77208

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS

LEGISLATIVE UPDATE February 4, 2009 Lunch Speaker

Synopsis Insurance fraud legislation being prepared for the Texas legislative session. Biography Mark Hanna was born and raised in Breckenridge, Texas, home of the Breckenridge Buckaroos. He attended college at Tarleton State University and graduated from the University of Texas at Austin with a degree in broadcast journalism. Hanna worked for several radio stations in Texas and then moved into television news in Austin where he served as an anchorman for KTBC-TV for eight years. After TV, he headed up public relations for the University of Texas System. He later produced the Dr. Red Duke health reports, before joining the Texas Department of Insurance where he worked under four insurance commissioners. For the past five years Hanna has served as manager of public relations and membership for the state insurance trade association, the Insurance Council of Texas. Contact Information Mark Hanna Insurance Council of Texas 2801 S. IH 35 Austin, TX 78701 512-444-9611

EFFECTIVE REPORT WRITING February 4, 2009 1:30– 3:00

Synopsis Investigations of ongoing criminal conduct, such as white-collar crime schemes or commercial insurance frauds, are complex and tedious. Investigators must report their findings in ways that do not comport to routine single transaction incident reporting formats. Chief Williams will discuss ways to convey complex information for easy understanding. The discussion will include non-standard report writing formats and procedures. Biography Chief of Police Howard E. Williams has 30 years of law enforcement experience. He was appointed Chief of the San Marcos (Texas) Police Department in July 2003. Before that, he served 25 years with the Austin Police Department, rising through the ranks from Patrol Officer to Police Commander. During his career, Chief Williams has worked assignments in patrol, criminal investigations, narcotics, community services, inspections, training, and organized crime. He has received many department awards including two Meritorious Unit Citations, the Meritorious Service Award, and the Superior Service Award for Community Service. He also received several community awards including a US Department of Justice Certificate of Appreciation, the Texas Commission on Law Enforcement Officer Standards and Education (TCLEOSE) Academic Recognition medal, the Dispute Resolution Center Peacemaker Award, the Fox 7 News Person of the Week for Outstanding Community Service Award, and the Gary Job Corps Excellence in Public Service Award. Chief Williams earned a Bachelor of Applied Arts and Sciences and a Master of Science in Criminal Justice from Texas State University / San Marcos. He is also a graduate of the Leadership and Command College of the Law Enforcement Management Institute of Texas at Sam Houston State University in Huntsville, and he holds a Master Peace Officer Certificate from TCLEOSE.

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Biography, continued Chief Williams has served on the TCLEOSE Education Committee and on the US Justice Department’s Law Enforcement Coordinating Committee for the Western District of Texas. He has also been an advisor to the Texas Bar Association Continuing Education Program. He is a member of the Texas Police Chiefs’ Association, the Police Executive Research Forum, and the International Association of Chiefs of Police. Currently, he serves as vicepresident of the Hays County Criminal Justice Association and president of the Gary Job Corps Community Relations Committee. Additionally, Chief Williams is a lecturer in the Department of Criminal Justice at Texas State University, where he teaches courses in introduction to criminal justice, management of criminal justice organizations, juvenile justice, and forensic evidence. He has written three textbooks in police science: INVESTIGATING WHITE COLLAR CRIME: Embezzlement and Financial Fraud, which is in its second edition, ASSET FORFEITURE: A Law Enforcement Perspective, and TASER ELECTRONIC CONTROL DEVICES AND SUDDEN IN-CUSTODY DEATH: Separating Evidence from Conjecture. Contact Information Howard Williams San Marcos Police Department 2300 IH-35 S. San Marcos, TX 78666 512-753-2100

DRUG DIVERSION February 4, 2009 1:30 – 3:00

Synopsis Course will touch on Fraud investigations in pharmacy and how they relate to health care fraud. The presenter will discuss why drugs are diverted, impact on health care system, diversion schemes, false insurance and Medicaid fraud claims, methods to stop pharmacy fraud, and what law enforcement is seeing on the streets. Biography Robert Ebrom Jr. is the Chief Law Enforcement Investigator for the Texas State Board of Pharmacy. Have served 31 years in Law Enforcement, ten as Chief Deputy Sheriff, 13 as a Municipal Police Officer, and eight as a Pharmacy Board Officer. Ebrom has worked the majority of his career in South Texas working all types of Criminal Cases. During his career Ebrom worked street narcotics, Highway Road Interdiction, and served as a Task Force Officer. Ebrom currently supervises seven investigators who focus on Diversion of Pharmacy Drugs from licensed facilities in the State. The Pharmacy Board receives loss reports each year where millions of dosage units of controlled drugs are taken or diverted by pharmacy employees or people who handle the controlled drugs. The Pharmacy Board handles both criminal and administrative cases to resolve these issues. Ebrom currently splits his time between the headquarters in Austin and the San Antonio Region, working with State and Federal Investigators to try to counteract a growing trend in today’s society.

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Texas Department of Insurance th 11 Annual Fraud Conference PRESENTER INFORMATION & PRESENTATION SYNOPSIS


Contact Information Robert Ebrom Texas State Board of Pharmacy-Police Unit 333 Guadalupe street, Suite 3-600 Austin, TX 78701 512-305-8042

ROUND TABLE February 4, 2009 3:15 – 5:00

Synopsis Panelist will answer questions from the audience. Kyson Johnson, Special Prosecutor for the TDI Fraud Unit, will act as moderator. The panelists include:     Robert Ebrom – Pharmacy Board Lisa Jones – Texas Board of Dental Examiners Scott Parker – Texas Board of Chiropractor Examiners Alan Moore & Mari Robinson – Texas Medical Board

Biographies Lisa Jones is the Director of Enforcement and Chief Law Enforcement officer for the Texas State Board of Dental Examiners. She has over 22 years of Law Enforcement Experience in both municipal policing and state regulatory enforcement and holds a Master Peace Officer certificate from the Texas Commission on Police Officer Standards and Education (TCLEOSE). Lisa’s primary duties as a municipal police officer were patrol, field training officer, crime prevention officer, DWI enforcement officer and patrol supervisor. She has been with the State Board of Dental Examiners for five years, with two years as a field investigator and three years as the Director of Enforcement. She is currently serving as the Secretary of the Texas chapter of the National Association of Drug Diversion Investigators (NADDI). Lisa also has a background in information technology as a network technician and system administrator for the Fort Worth Star-Telegram Online Services Division where she developed and managed the Customer Service Division for online services. Scott Parker started with the Harris County Sheriff’s Department in Houston in July 1971 and stayed with the County until 1976 when he went to work for the LaPorte Police Department, a suburb of Houston. In January 1984 Parker moved to Austin and went to work for the Travis County Sheriff’s Department. Parker remained with the County until retiring in December 2004 after 33 ½ years in law enforcement. During his tenure, he served as a patrolman; crime scene investigator; crime prevention specialist; field training officer; detective assigned to homicide, child abuse, burglary and juvenile units; fugitive warrant officer; SWAT Team member; Honor Guard team member; classroom instructor; firearms instructor; range master; and Sergeant. Parker is still commissioned as a Detective with Travis County SO. Parker was hired as Director of Enforcement by the Texas Board of Chiropractic Examiners in March 2007.

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ROUND TABLE, continued

Mari Robinson is the Interim Executive Director/Enforcement Director for the Texas Medical Board, an agency she joined in 2001. Prior to joining the agency, she worked for a short time in private practice in the area of civil litigation as well as for the Attorney General’s Office. In her current dual role, Mari oversees the agency in general, as well as in particular the enforcement groups responsible for regulating the practice of medicine in Texas, including the investigation, litigation, and compliance departments. She a law degree from The University of Texas School of Law. Dr. Alan Moore graduated with honors from the University of Texas at Austin and the University of Texas Southwestern Medical School as a member of the Alpha Omega Alpha Honor Society. He also received the Stembridge Award as the outstanding pathology student. Dr. Moore completed his anatomic and clinical pathology residency at Parkland Memorial Hospital in Dallas, and served as chief resident during his fourth year. Following his residency he completed a hematopathology fellowship at Parkland. He is board certified by the American Board of Pathology in anatomic pathology, clinical pathology, and hematopathology. Dr. Moore practiced pathology in Austin, Texas with Clinical Pathology Associates for more than 20 years. He has served as president of Clinical Pathology Associates, a member of the Board of Directors of Clinical Pathology Laboratories, medical director of the Seton Medical Center Laboratory, chief of staff of Seton Medical Center, and president of the Texas Society of Pathologists. Dr. Moore has also served as the transplant pathologist for the Seton Medical Center Cardiac Transplant Program. Contact Information Lisa Jones Texas Board of Dental Examiners 333 Guadalupe St, Tower III, Suite 800 Austin, Texas 78701 Scott Parker Texas Board of Chiropractor Examiners 333 Guadalupe St, Tower III, Suite 825 Austin, Texas 78701 Alan Moore & Mari Robinson Texas Medical Board 333 Guadalupe St, Tower III, Suite 610 Austin, Texas 78701

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