Washington Dc Fraud Attorney - DOC

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					                    TRICARE HEALTH CARE FRAUD CONFERENCE 2005
            “Communicating the Anti-Fraud Message: TRICARE – Excellence with Integrity”
                                  Laguna Cliffs Marriott, Dana Point, CA
                                          June 1-3, 2005

Day One

7:00-8:15                      Registration and Information Desk/Continental Breakfast

8:15-8:30                      Presenting of the Colors – National Anthem
                               United States Marine Corp, Camp Pendleton Honor Guard
                               National Anthem – Ken Zimmerman, TMA

8:30-8:35                      Welcome
                               Rose Sabo, Director, TRICARE Management Activity, Program
                               Integrity Office

8:35-9:00                      Keynote Address – TRICARE Management Activity’s Successes
                               John Kokulis, Deputy Assistant Secretary of Defense (Health Affairs),
                               Health Budget and Financial Policy

9:00-9:15                      Commitment of the TROs to Anti-Fraud Efforts
                               Mr. Michael Gill, Director, TRICARE Regional Office- South

9:15-9:45                      Case of the Year/Contractor of the Year
                               Synopsis of Contractor Accomplishments: David Fisher, Director,
                               Management Control and Financial Studies, Resource Management
                               Awards Presented by: David Fisher and Rose Sabo
                               Assisted by Cindy Gonsalves, Supervisory Health Care Fraud Specialist,
                               TRICARE Program Integrity Office

9:45-10:00                     Break

10:00-11:00                    DOJ’s Commitment to Health Care Fraud Prosecutions
                               Dan Anderson, U.S. Department Of Justice, Main Justice, Assistant
                               Director, Commercial Litigation Section (Fraud), Civil Division

11:00-11:45                    The Case of the Forgetful Doctor - Case Discussion: US v. Little –
                               Jeannie M. Joseph, DOJ, Assistant United States Attorney, Central
                               District of California

11:45-1:00                     Lunch

1:00-1:45                      Our Partners in Communicating the Anti Fraud Message:
                               DCIS, OPM-OIG, HHS-OIG & FBI
                               Sharon Woods, DoD-OIG, Defense Criminal Investigative Service,
                               Special Agent in Charge, Southwest Field Office
                               Barbara Harriman, HHS-OIG, Inspector, Office of Investigations,
                               Investigative Resource Staff, Washington, DC
                               Margaret Lew, OPM-OIG, Special Agent, San Diego Office
                               Dan Martino, Supervisory Special Agent, FBI, Los Angeles, CA
                    TRICARE HEALTH CARE FRAUD CONFERENCE 2005
            “Communicating the Anti-Fraud Message: TRICARE – Excellence with Integrity”
                                      Sponsored by TRICARE

1:45-3:00                      Case Discussion on the 2005 Case of the Year Winner
                               A Panel Discussion: US v. Wetsman
                               Kathleen W. Clark, Former Assistant US Attorney, Civil Division
                               Yesmin Saide & Faith Devine, DOJ, Assistant United States Attorneys,
                               Criminal Division, Southern District of California
                               Colin Koscki, Special Agent, DoD-OIG, Defense Criminal Investigative
                               Service, San Diego Resident Agency
                               Gordon Klau, SA, Federal Bureau of Investigations, Atlanta Field Office
                               Adrian Bubb, SA, Health & Human Services Office of Inspector General
                               Sam Fergason, Senior Investigator, Program Integrity, Health Net
                               Federal Services
                               Margaret Lew, Former DOJ Auditor [Special Agent, OPM-OIG]
                               Lynwood Lary, Supervisory SA, California Department of Justice,
                               Bureau of Medi-Cal Fraud
                               Scott Rezendes, Special Agent in Charge, Western Region, OPM-OIG

3:00-3:15                      Break

3:15-4:00                      “Spencer for Hire”: Case Discussion on US v. Spencer
                               Karen Shifflett, Special Agent, DoD-OIG, Defense Criminal
                               Investigative Service, Southwest Field Office

4:00-4:45                      Panel on Fiscal Accountability
                               Reta Michak, TMA Contracting Officer Representative, Quality
                               Monitoring Contract
                               Kenneth Zimmerman, TMA Contracting Officer Representative,
                               Tichenor Contract
                               Dan Johnson, TMA, Health Care Fraud Specialist, Post Payment
                               Duplicate Audit Software

Day Two

7:00-8:00                      Continental Breakfast

8:00-8:15                      Announcements
                               Rose Sabo, Director, Program Integrity Office

8:15-9:15                      “Family Fortune: How to Make Millions by Upcoding”- Case
                               Discussion: US v. Janati
                               Steve Linick, DOJ, Assistant United States Attorney, Eastern District of
                               Virginia
                               Darlene Hoynes, Special Agent, Federal Bureau of Investigation, Falls
                               Church VA Field Office




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                    TRICARE HEALTH CARE FRAUD CONFERENCE 2005
            “Communicating the Anti-Fraud Message: TRICARE – Excellence with Integrity”
                                     Sponsored by TRICARE

9:15-10:15                     “Desperate Housewives” - Case Discussions: US v. Thomas and
                               US v. Belton
                               Jennifer Aldrich, DOJ, Assistant United States Attorney, District of
                               South Carolina

10:15-10:30                    Break

10:30-11:15                    “Days of Our Lives” - Case Discussion: US v. Day
                               Dwight Holton, DOJ, Assistant United States Attorney, District of
                               Oregon
                               Kevin Burke, DOJ, Investigator, District of Oregon
                               Richard Salvin, Special Agent, DoD-OIG, Defense Criminal
                               Investigative Service, Seattle Resident Agency

11:15-12:15                    Can Fraud Occur in the Military Treatment Facility?: US v. Segura
                               Michael Theis, DOJ, Assistant United States Attorney, District of CO

12:15-1:15                     Lunch

1:15-2:00                      Fraud: The Insult to Injury Factor in High Health Care Costs!
                               William Mahon, Principal, LECG, LLC, Washington, DC

2:00-5:00                      Life Cycle of a Health Care Fraud Case: Four Vital Steps

2:00-2:30                      Step 1: The Contractor’s Role: “Just the Facts, Ma’am”
                               Sam Fergason, Senior Investigator, Program Integrity, Health Net
                               Federal Services

2:30-3:15                      Step 2: TMA-PI: “Law & Order – Program Oversight”
                               Cindy Gonsalves, TMA, Supervisory Health Care Fraud Specialist
                               Judy Russell, TMA, Health Care Fraud Specialist
                               Dan Johnson, TMA, Health Care Fraud Specialist

3:15-3:30                      Break

3:30-4:00                      Step 3: DCIS: “Book’em Dano!”
                               Colin Koscki, Special Agent, DoD-OIG, Defense Criminal Investigative
                               Service, San Diego Resident Agency

4:00-5:00                      Step 4: DOJ: “Criminal Intent - The Prosecution Rests”
                               Larry Casper, DOJ, Assistant United States Attorney, Southern District
                               of California




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                    TRICARE HEALTH CARE FRAUD CONFERENCE 2005
            “Communicating the Anti-Fraud Message: TRICARE – Excellence with Integrity”
                                     Sponsored by TRICARE

Day Three

7:00-7:45                      Continental Breakfast

7:45-8:00                      Announcements

8:00-9:00                      Pharmacy Fraud – Case Development, Tools & Case Examples
                               Dwayne Luby MBA, CPA, CFE, AHFI, Senior Director, Pharmacy
                               Compliance and Program Integrity, Express Scripts, Inc. (ESI)
                               Dan Geiger CFE, AHFI, Director, ESI Program Integrity
                               Andrea Lopez, AHFI., Senior Investigator, ESI Program Integrity

9:00-9:45                      A Wolf in Sheep's Clothing: Consultants and Billing Fraud
                               James Sheehan, Department of Justice, Associate United States Attorney,
                               Eastern District of Pennsylvania

9:45-10:00                     Break

10:00-10:45                    “The Rite Stuff” - Case Study: Rite Aid
                               K.T. Newton, DOJ, Assistant United States Attorney, Eastern District of
                               Pennsylvania

10:45-1130                     Contractor Roundtable Sessions – Networking at its Best!
                               Tom Luckett, Humana Military Healthcare Services
                               Chad Turner, Health Net Federal Services, Inc.
                               John Taylor, TriWest Healthcare Alliance
                               Steve Connaghan, United Concordia Company, Inc.
                               Dan Geiger, Express Scripts, Inc.
                               LTC Don DeGroff, Pharmacy Data Transaction Service
                               John Pabich, Wisconsin Physician Services

11:30-12:15                    “All in a Day’s Work” – Case Discussion: US v. Resource Sharing
                               Provider
                               Leif Johnson, DOJ, Assistant United States Attorney, District of
                               Montana

12:15-1:00                     “Home Alone” - Fraud in Home Health Care
                               Wendy Weiss, DOJ, Assistant United States Attorney, Central District of
                               California
                               Linda Foster, DOJ, Investigator, Central District of California

1:00-1:05                      Closing Remarks
                               Ms. Rose Sabo, Director Program Integrity Office




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