September 10, 2019 IME Committee Fraud & Abuse Discussion
2 IME Advisory Committee Schedule ▪ IME Provider Access – Thursday, March 14 ▪ Scheduling & Timing – Tuesday, April 9 ▪ Injured Worker Experience – Wednesday, May 8 ▪ Cost of IMEs and IME Entity Panel – Thursday, June 13 ▪ Quality of Reports and Technical Issues – Tuesday, July 9 ▪ Process and IME Member Questionnaire – Wednesday, August 7 ▪ Fraud & Abuse / Review Questionnaire Responses / Initial Draft Report Tuesday, September 10 ▪ Discuss Revised Draft Report – Thursday, October 10 ▪ Draft Report – Wednesday, November 13 ▪ Final Report – Thursday, December 12 2
3 Agenda & Topics for IME Fraud & Abuse Agenda Topic Time Allocation IME Fraud & Abuse Fraud Inspector General Presentation & Discussion 60 minutes Break 15 minutes Review Advisory Committee Questionnaire Responses 45 minutes Review Advisory Committee Recommendations Report DRAFT 45 minutes Wrap-up and Overview of October meeting 15 minutes 3
4 IME Fraud & Abuse Audrey Maiello Cunningham ▪ Deputy Inspector General for Workers' Compensation Fraud ▪ Office of the New York State Inspector General 4
5 IME Fraud & Abuse Questions? 5
6 Discussion Fraud & Abuse Issues? Recommendations? 6
7 Consensus on topic? 7
8 15-minute break 8
9 Injured Worker IME Questionnaire Injured Worker Demographics Injury Information Work Status Initial Complaints Current Complaints Medical Treatment & Medications Related Medical History Physical Examination 9
10 Committee Recommendations Questionnaire Responses Please see handouts 10
11 Recommendations Report Draft Please see handout 11
12 Next Meeting Thursday, October 10 th 12pm-3pm Send questions/comments to IMEAdvisory@wcb.ny.gov if you will not be present for this meeting 12
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