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ABOUT US |
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Provider Fraud Consultants, Inc. (PFC) |
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Daniel J. Osborne, M.S., Founder & President 18065 238th Street, Tonganoxie, KS 66086 (913) 669-6987 cccpfc@gmail.com |
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Curriculum Vitae Daniel J. Osborne, M.S. GENERAL BIOGRAPHY:
1976-1981, (Artillery Surveyor; Intelligence Analyst) U.S. Army 1981-1982, Police Officer, Knob Noster, MO 1982-1987, Deputy Sheriff, Johnson County, MO 1987-1988, Volunteer in Probation & Parole, Warrensburg, MO 1988, Law Enforcement Instructor, Tarkio College, Kansas City, MO 1988-1997, Special Agent, Insurance Crime Prevention Institute/National Insurance Crime Bureau 1997-present, President, Provider Fraud Consultants, Inc. /dba Chiropractic Compliance Consultants
UNDERGRADUATE / GRADUATE / OTHER STUDIES:
1987, Bachelor of Science, Industrial Security, Central Missouri State University 1988, Master of Science, Criminal Justice Administration, Central Missouri State University 1994, Media Spokesman Training, Media Strategy Training Center 1995, Train the Trainer, American Management Association 1998, Corporate Compliance for Medical Staff Leaders, OPUS Communication 1998, Advanced Compliance, HCCA Annual Compliance Institute 1999, HCCA Academy of Health Care Compliance, University of Pennsylvania 1999, Second Annual National Congress on Healthcare Compliance, HCCA
PROFESSIONAL AFFILLIATIONS:
1991-1992, Eastern Missouri Health Care Fraud Task Force 1992, Eastern Missouri Insurance Fraud Task Force 1992-1993, Western Missouri Board of Healing Arts AdHoc Group 1992-1995, Western Missouri Health Care Fraud Task Force 1993-1997, Eastern Nebraska Anti-Fraud Association 1993-1995, (Kansas City) Metro Area Insurance Fraud Task Force 1994-1998, Iowa Regional Health Care Anti Fraud Association 1995, Kansas Health Care Fraud Task Force Working Group 1997-1998, Ohio Insurance Fraud Task Force 1998-2000, American Compliance Institute 1998-2000, Health Care Compliance Association 1999-2001, Ohio State Chiropractic Association 1999-present, American Health Information Management Association 2003-2005, Fraud Committee, Federation Chiropractic Licensing Boards 2004-present, Post Graduate Faculty, National University of Health Sciences 2004-2005, Speakers Bureau, NCMIC Group 2007-present, Reimbursement & Technology Committee, ACN Group
PROFESSIONAL EXPERIENCE:
(Investigations /Prosecutions) 1991–1997, Assisted on extensive investigations/prosecutions of provider fraud 1992, Assisted with creation of Eastern Missouri Insurance Fraud Task Force, St. Louis, MO 1993, Assisted with creation of Metro Area Insurance Fraud Task Force, Kansas City, MO 1993, Assisted in furthering Health Care Fraud Fast Track Program, Chicago, IL 1994, Assisted with creation of Western Missouri Auto Theft Task Force, Kansas City, MO 1996-1997,created provider fraud work group of insurers, regulators, providers & law enforcers, OH 1996, Tarrant County District Attorney’s Office, Ft. Worth, TX 1997, State Farm Insurance, Dayton, OH 1997, Federal Bureau of Investigation, Columbus & Dayton, OH; Springfield, MO 1997, Ohio Board of Chiropractic Examiners, Columbus, OH 1998, Assisted health care provider on investigation of telemarketing scheme, MO 1998-present, Assisted providers and counsel with investigative services, TX, OH, MD, WA, NJ 2002, Expert in administrative hearing, Las Vegas, NV 2002-present, West Virginia Chiropractic Board, Charleston, WV 2003, U.S. Postal Service, OIG, Kansas City, MO 2004, U.S. Postal Service, OIG, Indianapolis, IN 2004, U.S. Attorney’s Office, Columbus, OH 2004-2005, Federal Bureau of Investigation, Salt Lake City, UT
(Presentations: Provider Fraud) 1992, Kansas Board of Healing Arts, Topeka, Kansas 1993, Chiropractic fraud seminar for federal law enforcers, Kansas City, MO & Columbus, OH 1993, State Farm Insurance, Kansas City, MO 1993, Eastern Nebraska Anti Fraud Association, Omaha, NE 1994, Professional Insurance Agents Association, Overland Park, KS 1994, Farmers Insurance, Shawnee Mission, KS 1995, Omaha Property & Casualty, Omaha, NE 1995, Federal Bureau of Investigation, Kansas City, MO 1996, 1997, State Farm Insurance, Cincinnati & Dayton, OH 1996, Liberty Mutual Insurance, Cincinnati, OH 1996, Nationwide Insurance, Cincinnati, Marietta & Columbus, OH 1996, Kemper Insurance, Columbus, OH 1996, Ohio Department of Insurance, Columbus, OH 1996, Ohio Board of Chiropractic Examiners, Columbus, OH 1996, 1997, Federal Bureau of Investigation, Columbus, OH; New York, NY 1996, Celina Insurance, Celina, OH 1996, Phoenix Management Enterprises, Cleveland, OH 1996, Ohio Attorney General’s Conference on Law Enforcement, Columbus, OH 1996, 1997, Progressive Insurance, Cleveland, Ohio; New York, NY 1996-1997, Health care provider fraud training for NICB Managers and Special Agents 1997, Insurance Investigator Seminar, Los Angeles, CA 1997, American Academy of Neurology, 49 Conference, Boston, MA 1998, American College of Forensic Examiners, Naples, FL 2004, National Health Care Anti-Fraud Association, Las Vegas, NV 2005, FBI Health Care Fraud Managers Conference, Atlanta, GA 2008, Para Transit Insurance, Memphis, TN
(Compliance) 1997-present, Audits & other Compliance services for providers in numerous states 2002-2006, Audit & Compliance services, Northwestern Health Sciences University, St. Paul, MN 2002, Approved Compliance Officer by TX Work Comp for DC under consent agreement 2002, Approved Compliance Officer by MA Chiro Board for DC’s under consent agreements 2004, Approved Compliance Officer by WV Chiro Board for DC’s under consent agreements 2009, Approved Compliance Officer by NV Chiro Board for DC’s under consent agreements
(Presentations: Health Care Fraud/Abuse & Compliance) 1997, Ohio State Chiropractic Association Annual Convention, Columbus, OH 1997-present, Health care fraud/abuse & compliance for providers at various locations in the US 2001, ACA/NCMIC Seminar, East Elmhurst, New York; San Diego, CA 2001, Minnesota Chiropractic Association, St. Paul, MN 2001, Independent Chiropractic Examiners Society, New York, NY 2001, West Virginia Chiropractic Society, Chester & Charleston, WV 2001, Chiropractic Law Seminar, TCA, Dallas, Fort Worth, Corpus Christi & Houston, TX 2002, Massachusetts Chiropractic Society, Waltham, MA 2002, Federation Chiropractic Licensing Boards, Chicago, IL 2003, Federation Chiropractic Licensing Boards, Orlando, FL 2004, Federation Chiropractic Licensing Boards, Denver, CO 2004, Palmer Chiropractic College, Davenport, IA 2004, Florida Chiropractic Association, Ft. Lauderdale, FL 2005, Florida Chiropractic Association, St. Augustine, Boca Raton, Orlando & Naples, FL 2006, South Dakota Chiropractic Association, Rapid City, SD 2007, South Dakota Chiropractic Association, Pierre, SD 2007– 2009, DJR Consulting, St. Louis, MO
PROFESSIONAL PUBLICATIONS:
Contributor, “Costly Deceptions”, Kansas City Business Journal, Oct. 21-27, 1994 Author, “Criminals Who Happen to be Doctors”, John Cooke Fraud Report, Jan/Feb 1997 Contributor, “Medical Clinic Investigations”, Claims, March 1997 Author, “Health Care Fraud-Join the Fight”, PSN NETWORK NEWS, 1998 Author, “Multidiscipline Practices”, Dynamic Chiropractic, July 12, 1999 Contributor, “The Multidiscipline Practice”, Journal of American Chiropractic Assoc. Dec. 2000 Author, “Eye on Compliance”, NCMIC Examiner, Fall 2001 Author, “The Importance of CPT Codes”, NCMIC Examiner, Winter 2001-2002 Author, “Why You Need a Compliance Program”, NCMIC Examiner, Spring 2002 Author, “Professional & Technical Components”, NCMIC Examiner, Summer 2002 Author, “Do You Commit Accidental Fraud”, Chiropractic Economics, Issue 12, September 30, 2003 Author, “Nat’l Ins. Fraud Seminar Focuses on Chiropractic:, Dynamic Chiropractic, Nov. 17, 2003 Author, “Feds Focus on Practice Builders”, Florida Chiropractic Association, Winter 2004 Author, “Rehab by Unlicensed Providers”, Chiro-Code, March 2004 Author, “Prosecutors’ New Target, Services by Unlicensed Staff”, NCMIC Examiner, Fall 2004 Author, “Know Your Fraud”, Chiropractic Economics, Issue 13, September 15, 2005 Author, “Whom Do You Use For Compliance”, Dynamic Chiropractic, July 30, 2007 Author, “Therapeutic Procedures, Explode Your Practice”, Zalma Newsletter, July 2007 Author, “Investigating Health Care Fraud”, Ezine Articles, July 2008 Author, “The Next Generation of Multi-Discipline Practice Fraud”, Ezine Articles, July 2008 Author, “Health Care Compliance, Buyer Beware”, Ezine Articles, July 2008 Author, “TENS, Increase Your Profit Margin?” Ezine Articles, July 2008 Author, “Investigating Chiropractic Fraud”, Ezine Articles, July 2008 Author, “Health Care Fraud-The Costly Deception”, Ezine Articles, Aug. 2008 Author, “9 Biggest Mistakes Health Care Providers Make…”, Ezine Articles, Sept. 2008 Author, “Chiropractic Fraud, Perception v. Reality”, Ezine Articles, Sept. 2008 Author, “Position of Strength or How to Paint Target on Your Back”, Ezine Articles, Oct. 2008 Author, “Chiropractic Fraud, Could Perception Be Reality?”, Ezine Articles, Feb. 2009 |
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Daniel J. Osborne, M.S., founded Provider Fraud Consultants, Inc. (PFC), dba Chiropractic Compliance Consultants (CCC) in 1997 to assist health care providers, insurers, regulators, law enforcers and others on increasing practice certainty and bolstering fraud-fighting successes! Specializing on Chiropractic and PM&R, PFC has an extensive investigative and compliance background: ...trained by Health Care Providers on using clinical & billing records to detect health care fraud & abuse ...conducted / assisted on extensive health care fraud investigations, including those with national significance ...assisted on the prosecutions of health care fraud subjects, including those having national significance ...participated in Federal & State health care fraud task forces ...created working groups of providers, insurers & law enforcers to address health care fraud ...set the foundation for NICB’s Medical Provider Fraud Units ...expert witness in administrative, civil and criminal health care fraud proceedings ...extensive education & training programs for insurers, law enforcers & regulators on health care fraud topics to enhance successes on identifying, investigating and prosecuting health care fraud ...presented Chiropractic Fraud at the FBI Health Care Fraud Managers Conference ...presented Next Generation of Multidiscipline Fraud at NHCAA conference ...published author on health care fraud & compliance topics ...extensive education & training programs for Health Care Professionals on Health Care Fraud/Abuse & Compliance to increase practice certainty ...past speaker for the NCMIC Speaker’s Bureau ...former representative on the FCLB Fraud Committee ...assisted providers with audit services to proactively detect & correct problems ...assisted providers with implementing & administering compliance programs ...approved compliance officer by regulators for providers under consent agreements ...assisted providers on responding to payor audits and allegations of misconduct |
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