Events Calendar
Fraud and Abuse Workgroup Meeting 12-13-2010
2010-12-13, 9:00am to 12:00pm, 630 Davis Dr., Suite 100 Morrisville, NC 27560
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This event is related to the Health Reform: Fraud and Abuse Workgroup Task Force.
Agenda
» Download the9:00-9:15 Welcome and Introductions
Albert P Koehler, Deputy Commissioner/Director
Criminal Investigations Division
NC Department of Insurance
Co-Chair
Tara Larson, Chief Clinical Operations Officer
Division of Medical Assistance
Co-Chair
9:15-9:30 Current Status of Gap Analysis
Tracy Hayes, Assistant Attorney General
NC Department of Justice
9:30-11:30 Workgroup discussion
Status of recommendations from last meeting: development of legislation
• Identification of high risk providers
• Compliance programs
• Automatic communication – triggers, referrals, quarterly meetings – between insurers, provider boards, provider associations
• Criminal background checks
Billing Agents (Presenter: Rose Shattuck)
• What defines a billing agent?
• What is the gap in education on ACA requirements for billing agents? Who’s providing this education?
• What rules or legislation do we need to develop?
How does the public system impact private payors?
• Who should be the “responsible parties” for coordinating public and private payors?
• What rules or legislation do we need to develop?
County DSS recipient/fraud
• What education needs to be provided to the public, and who should provide it?
• What rules or legislation do we need to develop?
11:30-11:45 Plans for next meeting
11:45-12:00 Public comment period
Presentations and Handouts
