Orlando, February 25, 2003 Mathias Consulting lead a workshop on how to minimize fraud and abuse in managed care.

During this workshop learn how to recognize and prevent claims fraud and abuse from the professionals at Mathias Consulting. Managed care programs that proactively identify, investigate and deter fraud, waste and abuse gain a competitive edge and stronger voice in how practice guidelines, payment procedures and compliance are implemented. Rapidly growing healthcare and a stalled economy pressure Medicaid and Medicare to cut costs. Medicare and Medicaid programs are examining the effectiveness of treatments, utilization patterns and fraud and abuse. Not only is 10-25% of health spending fraudulent, at least as much spending is legal but wasteful. As programs work to save money managed care organizations will be expected to play a larger role in identifying and ending fraud, waste and abuse in Medicare and Medicaid managed care. The first half of this workshop focuses on:

• Initiating fraud, waste, and abuse controls
• How streamlining and process changes may increase fraud and abuse
• Fraudsters adapt to change faster than you do
• Why compliance isn?t good enough
• Developing practice guidelines to control waste
• Implementing fraud, waste and abuse detection
• Building alliances with Medicare and Medicaid to control costs

In the second half of the workshop, the authorities from the Centers for Medicare and Medicaid Services provide an overview of the Model for 2004 and strategies to improve:

• Risk Adjusted Payments
• Collection of Data
• Obtaining Encounter Data

Who Should Attend:

• Claims Managers, Directors, and Supervisors
• Compliance Officers
• Provider Relations
• Customer Service
• Case Management

Workshop Leaders:
Robin Mathias, MPA, Principal, MATHIAS CONSULTING, and
Former Director of Data Analysis and Budget, INDIANA MEDICAID

And
Senior Representatives from the CENTERS FOR MEDICAID AND MEDICARE SERVICES (CMS)