2019 Healthcare Fraud Summit Program

 

Dan Harkness
FBI Supervisory Special Agent,
Healthcare Fraud Unit,
FBI Headquarters, Washington, DC


Daniel Harkness is a Supervisory Special Agent (SSA) in the Health Care Fraud Unit of the Federal Bureau of Investigation (FBI) in Washington, D.C. SSA Harkness holds a Master of Public Administration from Brigham Young University and a Bachelor of Science from the University of Utah with a minor in Economics. He entered New Agent’s Training at Quantico in September 2008. After graduation, he was assigned to the New Haven Field Office, assigned to the Safe Streets Task Force, then to a White Collar (WC) Squad, with an emphasis on healthcare fraud. In April 2014, SAA Harkness was transferred to the Sacramento Field office, to a WC squad working health care fraud violations. In October 2017, he was promoted to FBI Headquarters to work in the Domestic Terrorism Operations Unit. In May 2019, SSA Harkness joined the Health Care Fraud Unit at FBI Headquarters.

Overview of Healthcare Fraud

Content Description


SSA Harkness will speak on current health care fraud schemes the FBI is currently tracking from an investigators perspective.

The presentation will include brief history of healthcare and healthcare fraud in the US.

Learning Objectives


Upon completion of this session, learners should be better prepared to:

  • Identify healthcare fraud schemes.

 

Kyle King, FBI Special Agent , Birmingham Division
Special Agent Jeff Inman, U.S. Health and Human Services, Office of Inspector General (co-presenter)
Opioids and Healthcare
Blake-Henson-Pic

Blake Henson Esq.
Network Integrity Manager

Blue Cross and Blue Shield of Alabama


Mr. Henson has over 8 years of  experience serving in various roles at Blue Cross Blue Shield of Alabama. Most recently he serves in the Legal Services Division as the Manager of Network Integrity where he is responsible for the daily management of staff responsible for the detection, case development and remediation of suspected Fraud, Waste and Abuse. Mr. Henson is a licensed attorney in the state of Alabama.

Healthcare Fraud; A Payer’s Perspective

Content Description


Healthcare fraud is the intentional deception, concealment or misrepresentation an individual or entity makes knowing the misrepresentation could bring some benefit to them or another party they are not legally entitled to receive. Providers should be aware of the basic elements of healthcare fraud and what role payers play in combating healthcare fraud. During this session, the speaker will: discuss why and how healthcare fraud occurs, discuss the federal and state law enforcement environments, provide examples of known schemes and discuss how providers can protect their practices. An understanding of these elements will assist providers in avoiding any possible violations.

Learning Objectives


Upon completion of this session, learners should be better prepared to:

  • Define the nature and scope of healthcare fraud
  • Discuss why and how healthcare fraud occurs
  • Understand federal and state law enforcement environments
  • Understand how you can protect your practice
J B Ward – United States Attorney, Northern District of Alabama To Be Announced
Robertson_BradBrad Robertson
Partner
Bradley Arant Boult Cummings LLP


Brad Robertson advises and defends clients facing government investigations and litigations, dealing
with whistle-blower allegations and qui tam actions, and planning compliance programs to prevent these occurrences in the first place. He helps his clients navigate compliance and potential liability under the False Claims Act and Anti-Kickback Statute, in addition to other areas of healthcare fraud and abuse and
white collar criminal law.

Navigating Qui Tam/Whistle-blower Actions

Content Description


The False Claims Act is one of the federal government’s primary tools to combat Medicare and Medicaid fraud and abuse. Private citizens may also bring actions under the statute’s whistle-blower provisions. Whether based on violations of the Anti-Kickback Statute, violations of the Stark Law, coding issues, documentation issues, or otherwise, healthcare providers may find themselves facing astronomical damages and penalties if they are not careful. Providers should be aware of the pitfalls that may result in liability. During this session, the speaker will explain liability under the False Claims Act, describe the qui tam whistle-blower provisions, and give specific examples of situations that may result in liability. An understanding of these elements will assist providers to
avoid and/or prevent possible violations.

Learning Objectives


Upon completion of this session, learners should be better prepared to:

  • Define the elements of the False Claims Act, including penalties and whistleblower provisions
    (knowledge)
  • Identify common defenses to False Claims Act allegations (knowledge)
  • Demonstrate best practices upon receipt of a government inquiry (competence)
Jim Sturdivant – Sirote & Permutt To Be Announced
Legal Round Table

Moderator:
Jeff Dance
Kassouf Healthcare Solutions

D J Simmonetti

J B Ward

Brad Robertson

Jim Sturdivant