30th Annual Anti-Fraud Conference Tentative Schedule
30th Annual Anti-Fraud ConferenceTentative Schedule(Classes, titles, subjects, times, and instructors are subject to change.)Presented by AFA, CDI, CDAA and NICBwww.annualantifraudconference.comHyatt Regency Monterey HotelMonterey, CaliforniaApril 17 - 19, 2019SCHEDULE OF EVENTSTUESDAY, APRIL 16, 20197:30 A.M. – 12 Noon30th Annual Anti-Fraud Conference Golf TournamentOld Del Monte Golf Course, Hyatt Regency12:00 P.M. – 5:00 P.M.Conference Registration Opens – Conference Center Foyer1:00 P.M. – 5:00 P.M.Exhibitor Set-Up5:30 P.M. – 7:00 P.M.Networking Reception - First Quarterly AFA Meeting and AttendeeWelcome Reception - Hyatt Regency President’s HouseWEDNESDAY, APRIL 17, 20197:00 A.M.Conference Registration Opens - Conference Center Foyer7:30 A.M.Exhibitor’s Hall Opens – Conference Center1
GENERAL SESSIONRegency Main8:00 A.M. – 9:00 A.M.Jay Bobrowsky, AFA President, Supervisor, EmployersRicardo Lara, California Insurance CommissionerNancy O’Malley, Alameda County District Attorney and CDAArepresentativeJeannine M. Pacioni, Monterey County District AttorneyGeorge Mueller, Deputy Commissioner, Enforcement Branch, CaliforniaDepartment of InsuranceRon Michel, Supervisory Special Agent, NICB9:00 A.M. – 10:00 A.M.Assembling a Compelling CaseJennifer Lentz Snyder, Head Deputy, Healthcare Fraud Division, LosAngeles County District Attorney’s Office10:00 A.M. – 10:15 A.M.Break10:15 A.M. – 11:45 A.M.Fraud and National News – CBS - 48 HoursPeter Van Sant, News Reporter and Correspondent, 48 hoursGreg Fisher, West Coast Coordinator, 48 hours11:45 A.M. – 1:00 P.M.Lunch – Monterey BallroomBREAKOUT SESSIONS1:00 P.M. – 3:00 P.M.Social Media: Cultural Catastrophe or Evidentiary Goldmine? A Prosecutor’s PerspectiveRahul Gupta, Deputy District Attorney, Orange County District Attorney’s OfficeInvestigating Kickback SchemesNorm Levy, Investigator (retired), Santa Clara County District Attorney’s OfficeJon Atkinson, Investigator, Santa Clara County District Attorney’s OfficeJulie Sousa, Deputy District Attorney, Santa Clara County District Attorney’s OfficeCalifornia Criminal DiscoveryJeremy Seymour, Deputy District Attorney, Contra Costa County District Attorney’s Office2
New Technology in Investigations & Law EnforcementMichael Fabozzi, Detective, California Department of Insurance Fraud DivisionInvestigating and Prosecuting Drug Rehab Center Fraud: More Than Money, it’s About LivesShaun Gipson, Deputy District Attorney, Los Angeles County District Attorney’s Office3:00 P.M. – 3:15 P.M. BreakBREAKOUT SESSIONS3:15 P.M. – 5:15 P.M.SIU/Field Investigator Safety & TacticsJim Wesson, CEO, J.D. & Associates, Inc.Pharmaceutical frauds & associated kickbacks schemes: Identifying the hub of the scheme viaanalyticsMichael Stahl, D.C.Playing with Fire: Self-referrals, Kickbacks and Labor Code Sections 139.3 and 139.32Kate Zimmermann, Senior Deputy District Attorney, Kern County District Attorney’s OfficeJames Fisher, Counsel to the Administrative Director, Division of Workers’ CompensationLiving the Suite Life? Investigating and Defeating Fraudulent ALE (Additional Living Expense) ClaimsMike McKee, Senior Special Agent, National Insurance Crime Bureau (NICB)Pete Galassi, Special Investigations Unit Sr. Manager, Mercury InsuranceJonathan H. Colman, Managing Attorney, Colman Law GroupAutomotive Forensic LocksmithingChad Tredway, Forensics Locksmith, North America West Automotive Forensic Services5:30 P.M. – 7:00 P.M. Networking Reception – Hyatt Regency President’s HouseTHURSDAY, APRIL 18, 20197:30 A.M.Conference Registration Opens7:15 A.M.Exhibitor’s Hall Opens3
BREAKOUT SESSIONS8:00 A.M. – 10:00 A.M.Role of Medical Necessity in Medical Coding and documentationBeth Howard-Stalker, CEO, CostFirst, Corp.Bill Reynolds, Owner/Partner, First Investigation ServicesPlaying the Game – Understanding the Steps to Investigating Suspected Fraud (an interactive teamexperience) Part IGordon Oard, Senior Special Investigator, Berkshire Hathaway Homestate CompaniesDon Marshall, Vice President, Zenith Insurance CompanyVehicle Arson Investigations - Don't Get Burned!Ulises Castellon, CPCU, RPA Fire Cause AnalysisAndy Berasley, CFCI, CVFI, IAAI-FIT(V), Fire Cause AnalysisPremium Fraud and the Underground EconomyDominic Dugo, Chief Deputy, San Diego County District Attorney’s OfficeHindsight is 20/20: Prosecutor Perspectives on Effective Deposition for Criminal ProsecutionJill Nerone, Supervising Deputy District Attorney, Alameda County District Attorney’s OfficeLaura Meyers, Assistant District Attorney, San Francisco County District Attorney’s, OfficeNicole Pantaleo, Deputy District Attorney, Marin County District Attorney’s Office, InsuranceFraud Department Coordinator10:00 A.M. – 10:15 A.M. Break10:15 A.M. – 12:15 P.M.Investigating Fraudulent Vehicle Claims - Infotainment SystemsDr. James Mason, Ph.D., P.E., Senior Engineer, ARCCAPlaying the Game – Understanding the Steps to Investigating Suspected Fraud (an interactive teamexperience) Part IIGordon Oard, Senior Special Investigator, Berkshire Hathaway Homestate CompaniesDon Marshall, Vice President, Zenith Insurance CompanyInvestigating Fraud in the QME System (Ghostwriting and Over-Billing)Patrick Ward, Investigator, Santa Clara County District Attorney’s OfficeEthics for Prosecutors, Civil Attorneys, and Investigators in Fraud CasesTom Fraysse, Managing Partner, Know Ricksen, LLP4
Eric von Geldern, Deputy District Attorney, Alameda County District Attorney’s OfficeVic Pence, SIU Supervisor, Mercury InsuranceLiens and Their Potential Effect on Both Fraud and the Valuation of Medical Care - Legal and StrategicConsiderationsChristopher L. Patton, Attorney, McDowell Shaw & GarciaHenry Lubow, M.D., CEO, Injury Review, Inc.12:15 P.M. – 1:30 P.M.Lunch – Monterey BallroomGENERAL SESSION1:30 P.M. – 2:45 P.M.Opportunities, Threats and Challenges — Combating Fraud in a Changing AmericaDennis Jay, Executive Director, Coalition Against Insurance Fraud2:45 P.M. – 3:00 P.M.Break3:00 P.M. – 4:00 P.M. Exhibitor Hall Closes/ Exhibitor Tear-DownBREAKOUT SESSIONS3:00 P.M. – 5:00 P.M.Updates in Interviewing Medical ProvidersChris Robbins, Investigator, Orange County District Attorney’s OfficeBeyond the Unwitnessed Slip and Fall - Effective Investigation and Prosecution of Claimant FraudCasesAndrew J. Reid, Deputy District Attorney, Ventura County District Attorney’s OfficeJenifer Marquardt, Fraud Specialist, Zenith Insurance CompanyBattling Auto Insurance Fraud - A Proactive Undercover Approach to Auto Body ShopsDanny Lau, Deputy District Attorney, Alameda County District Attorney’s OfficeJohn Lee, Detective, California Department of Insurance, Fraud DivisionHow to Build an Affirmative Litigation Case – Client and Counsel PerspectivesLaura McAdams, Attorney, Manning & KassDennis Kass, Founding Partner, Manning and Kass, LLP5
Janine Farrell, Medical Fraud Investigator, Travelers InsuranceSupplemental Job Displacement Benefit (Voucher) FraudJulie Sousa, Deputy District Attorney, Santa Clara County District Attorney’s OfficeKaren Johnson, Investigative Enforcement Analyst, Bureau of Private Postsecondary EducationJames Fisher, Counsel to the Administrative Director, Division of Workers’ CompensationRichard L. Duffy, SIU Medical Fraud and Major Case Consultant, The Hartford5:30 P.M. – 7:30 P.M. 30th Annual Anti-Fraud Conference Reception – Monterey BallroomFRIDAY APRIL 19, 20197:30 A.M.Conference Registration OpensGENERAL SESSION8:30 A.M. – 9:45 A.M. Insurance Fraud in a Digital EnvironmentJoe Stephenson, Director, Digital Intelligence, INTERTEL, Inc.Michael Skiba, Vice President International Counter Fraud, INFORM9:45 A.M. – 10:00 A.M.Break10:00 A.M. - 11:45 A.M.From Detection to Conviction: Key Issues and Ethics HypotheticalsDale Banda, COO, J.D. Wesson & Associates, Inc.; CDI, Deputy Commissioner (retired)Eric von Geldern, Deputy District Attorney, Alameda County District Attorney’s OfficeJay Bobrowsky, SIU Supervisor, Employers Insurance11:45 A.M - 12 NoonConcluding Remarks & Gift Giveaway – Jay Bobrowsky, AFA President6
Apr 30, 2019 · Jill Nerone, Supervising Deputy District Attorney, Alameda County District Attorney’s Office Laura Meyers, Assistant District Attorney, San Francisco County District Attorney’s, Office Nicole Pantaleo, Deputy District Attorney, Marin County District Attorney’s Office, Insurance F
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Types of economic crime/fraud experienced Customer fraud was introduced as a category for the first time in our 2018 survey. It refers to fraud committed by the end-user and comprises economic crimes such as mortgage fraud, credit card fraud, claims fraud, cheque fraud, ID fraud and similar fraud types. Source: PwC analysis 2
Types of economic crime/fraud experienced Customer fraud was introduced as a category for the first time in our 2018 survey. It refers to fraud committed by the end-user and comprises economic crimes such as mortgage fraud, credit card fraud, claims fraud, cheque fraud, ID fraud and similar fraud types. Source: PwC analysis 2
Card Fraud 11 Unauthorised debit, credit and other payment card fraud 12 Remote purchase (Card-not-present) fraud 15 Counterfeit Card Fraud 17 Lost and Stolen Card Fraud 18 Card ID theft 20 Card not-received fraud 22 Internet/e-commerce card fraud los
Main Conference: July 11th & 12th, 2016 . 8 th ANNUAL. AML/CFT, Anti-Fraud and Financial Crimes Conference "Forging Alliances Regionally and Internationally to Combat Money Laundering, . Anti-Fraud & Financial Crimes Conference 2016. Cherise Cox-Nottage is presently the Head of the Legal Department for UBS (Bahamas) Ltd. A role which
Fraud risk management strategy Fraud prevention Anti-fraud culture Risk awareness Whistleblowing Sound internal control systems A fraud policy statement, effective recruitment policies and good internal controls can minimise the risk of fraud. Fraud detection Performing regular checks. Warning signals/fraud risk indicators:
Detection of Fraud Schemes Fraud is much more likely to be detected by tips than by any other method. 2012 Association of Certified Fraud Examiners, Inc. 26 Detection of Occupational Frauds 2012 Association of Certified Fraud Examiners, Inc. 27 Why Employees Do Not Report Fraud According to a Business Ethics Study (Association of Certified Fraud Examiners), employees do not .
Fraud by any other name is still fraud “Relatively few occupational fraud and abuse offenses are discovered through routine audits. Most Fraud is uncovered as a result of tips and complaints from other employees.” Association of Fraud
