Lunch & Learn

When: 2/7/2019 | Where: Rio Hondo Country Club

We hope to see you at our next Lunch and Learn scheduled for:

Thursday, February 7, 2019 from 10:00 a.m. to 3:00 p.m.

Speakers:

• Vicky Summogum RN, PHD, CPC, MFRS – Healthcare Resource Group
• Zazil Mijares BA, MCC, MFRS – Consulting Specialist
• Rik Chavez MD – Clinical Professor Geffen School of Medicine, UCLA

TOPIC: Fraud and Abuse in Substance Use

Location

Rio Hondo Country Club
10627 Old River School Rd
Downey CA 90241
Get Directions →

Hotel: https://www.riohec.com/

Speaker Information:

Vicky Summongum RN, PHD, CPC, MFRS
Medical Fraud Review Specialist
Clinical Director Medical SIU
Healthcare Resource Group. Buena Park CA.
 
Zazil Mijares BA, MCC, MFRS
Medical SIU Manager
Medical Fraud Review Specialist
 
Consulting Specialist
Rick Chavez MD
Medical Director
HealthCare Resource Group
Specialty: Pain Management, Addiction Medicine
Clinical Professor Geffen School of Medicine UCLA

TOPIC:  Fraud and Abuse in Substance Use Treatment Service Programs

PART 1:

• Delivery Method:
• Discussion on Substance use Disorders
• Types of Treatment Programs
• 23 hour observation
• Crisis stabilization
• Day treatment
• Inpatient
• Intensive outpatient
• Outpatient
• Partial Hospital
• Residential Treatment Center
• Fraud and Abuse in Substance Abuse Treatment Service Programs

The above will be presented in the first two hours

PART 2

• Questions and answer on Part 1 presentation
• Presentation of case study.
• Question and answer
  

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Costs:

Member Cost: $35
Non Member Cost: $45

Speaker: Jimmy Gomez, Department of Motor Vehicle

TOPIC: Fraudulent Document Detection (2 hours) and Identity Theft Training (2 hours)
This Training will provide information and skills necessary to recognize the characteristics and security features of legitimate Government-issued identification documents, which includes birth certificates, immigration documents, driver licenses and identification. cards, and, passports.  The student will be able to identify counterfeit legal presence identification documents.  Recognizing counterfeit Driver Licenses and Identification cards.  Specific laws regulating counterfeit documents and reference materials pertaining to the subject will be identified.  The course will also provide some basic guidelines to assist in investigating crimes involving counterfeit documents.  Also, the presentation will provide students with an understanding of identity theft crimes; an understanding of specific laws regulating identify theft.

Speaker: Andy Berasley, CFEI, CVFI, IAAI-FIT; Fire Investigator
Andrew Berasley is a certified fire investigator with the responsibility of managing and conducting vehicle fire investigations for Fire Cause Analysis. His years of experience include owning and operating his own auto repair facilities & collision company where he was directly responsible for mechanical issues on vehicles, trucks and heavy equipment. He currently works with law firms and the insurance industry, providing investigations and additional services in all fire-related disciplines including Fire Testing and Auto Related Mechanical & Electrical Studies. In addition, Mr. Berasley has given deposition and trial testimony in both civil and criminal cases.
Andrew Berasley is also responsible for all aspects of evidence recovery, handling & storage, and documentation of evidence, including supervising collection and evidence chain of possession at FCA’s facilities in Northern & Southern California and Arizona.

Speaker: KC Hester, CFI; Fire Investigator
KC Hester has over 15 years of professional experience in the fire service, serving in various capacities. He is a fire investigator with Fire Cause Analysis. He is also a certified forensic fire investigator with National Code Service Association. KC is a member of the Orange County Regional Arson Task Force and a terrorism liaison officer with the Fountain Valley Fire Department. He is an active member of the International Association of Arson Investigators, National Code Service Association, and California Conference of Arson Investigators. Mr. Hester is a California State Fire Marshal’s Office certified level II fire investigator and certified fire officer.

Mr. Hester is qualified to investigate fire scenes and explosions, locate the seat of the explosion or point of origin, determine the cause, and collect and record samples for laboratory analysis. Prepare investigation reports containing cause and origin analysis, witness statements, photographs, diagrams, and video when required, along with any other additional components. Conduct complete background investigations, surveillance, interview witnesses and is capable of giving expert testimony as to the results of these investigations. Conduct hazardous materials investigations of fires, spills, leaks and illegal discharges. A systematic approach using the Scientific Method as outlined in NFPA 921 is utilized when performing fire scene investigations.

Topic: “Vehicle Arson Investigations – Don’t Get Burned!”
This program utilizes visually compelling fire cases to illustrate effective vehicle forensic fire investigation involving: Private Passenger Vehicles, Recreational Vehicles, Trucks, and Heavy Equipment. The insurance claims professional’s responsibilities include the demanding challenge of evaluating the technical abilities of experts. They aren’t expected to be experts. They are expected to use good judgment and working with evaluating experts. This workshop is designed to provide thoughtful understanding among claims professionals to provide some tools and perspective to cost effectively utilize experts in the context an arson investigation without getting burned !

Speaker: David Kersh
David Kersh is the Executive Director of the Carpenters/Contractors Cooperation Committee (C/CCC). The C/CCC is a non-profit labor management organization that collaborates with local, state and federal civil and criminal law enforcement agencies to crack down on wage theft practices and payroll, tax and workers’ compensation premium fraud. Mr. Kersh has been at the forefront of regional efforts throughout the Southwest to promote the creation of fair competition and high quality in the construction industry.
Speakers: Teena Barton (SIU Invetigator – ICW Group Insurance) and Attorney Sean Enrique O’Keefe

TOPIC: FRAUD AND WAGE THEFT PRACTICES IN THE CONSTRUCTION INDUSTRY
&
TOPIC: AN INSIDE LOOK AT HEALTH CARE INSURANCE FRAUD SYNDICATES
Course Description: A unique perspective into the world of capping schemes, from their evolution, to detection, to defense, and a look inside of the schemes from an indicted attorney.

Indicted Attorney (‘I was greedy and stupid’: Workers’ comp attorney admits to bribes)

Speaker Information: Sergeant Jimmy Gomez, Department of Motor Vehicles.

TOPIC: Auto Dealer/ Salesperson Overview, investigations, fraud trends, case study on two top trends, Title Washing and VIN Cloning/Switching (stolen vehicles).