1. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy- making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. HEALTHCARE FRAUD PREVENTION PARTNERSHIP (HFPP) Overview June, 2013

2. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. ENDLESS OPPORTUNITIES….. HFPP Claims Compromised Patient Data Fraudulent Providers Partner #Z Partner #X Partner #Y Enhanced Fraud- Fighting Capabilities

3. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. PURPOSE OF THE HEALTHCARE FRAUD PREVENTION PARTNERSHIP (HFPP) To exchange facts and information between the public and private sectors in order to reduce the prevalence of health care fraud To enable members to individually share successful anti-fraud practices and effective methodologies and strategies for detecting and preventing health care fraud To focus on information sharing in two primary areas: Data sharing and analytics Outreach, education and information sharing

4. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. PROGRESS TO DATE Officially established by a Charter in fall 2012 Signed by HHS Secretary Sibelius and US Attorney General Holder Members joined from Federal & State government, private payers and associations Created operating structures and processes Established legal framework (e.g., MOU) Established regular meetings and coordination Completion of the First Information Exchange

5. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. CURRENT PARTNERSHIP AS OF APRIL 1, 2013 Federal Partners Department of Health and Human Services, Associate Deputy Secretary’s Office Department of Health and Human Services, Centers for Medicare and Medicaid Services Department of Health and Human Services, Office of the Inspector General Department of Justice, Criminal Division Department of Justice, Federal Bureau of Investigations State Partners Arizona Medicaid Office of the Inspector General, Arizona Health Care Cost Containment System New York Office of Medicaid Inspector General Iowa Insurance Fraud Bureau (NAIC’s representative on the Information Sharing Committee) Ohio Attorney General’s Office (NAMFCU’s representative on the Information Sharing Committee) Kansas Attorney General’s Office (NAMFCU’s representative on the Executive Board) Private Payers Aetna Amerigroup Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Louisiana Humana Independence Blue Cross Travelers Tufts Health Plan United HealthCare WellPoint Associations America's Health Insurance Plans (AHIP) Blue Cross and Blue Shield Association (BCBSA) Coalition Against Insurance Fraud (CAIF) National Association of Insurance Commissioners (NAIC) National Association of Medicaid Directors (NAMD) National Association of Medicaid Fraud Control Units (NAMFCU) National Health Care Anti-Fraud Association (NHCAA) National Insurance Crime Bureau (NICB)

6. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. STRUCTURES OF THE HFPP Executive Board Information Sharing Committee (ISC) Data Analysis & Review Committee (DARC) Study 1 Study 2 Study 3 Study 4Study 5 Trusted Third Party Life Cycle Team Study Pipeline Team TTP Strategy TTP NASA Challenge Other Teams Formal Structures Studies Planning Teams

7. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. DATA SHARING CONCEPT Trusted Third Party Government Partner #1 Government Partner #2 Private Payer #.... Private Payer #2 Private Payer #1 Study Selection Design & Planning Data Exchange TRUSTED 3 rd PARTY Partner Data Analysis & Actions Evaluation

8. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. ISC – EXTENT OF INFORMATION SHARING General Public HFPP Partner Extensions (e.g. association members) HFPP Full Partnership Participating Entities Each individual HFPP data exchange study will be analyzed to determine: 1.What level of data will reach each level? 2.What products will reach each level? 3.What special actions or considerations are needed for this data exchange ? 4.How do we measure success?

9. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. DARC - CONCEPTUAL STUDY LIFE CYCLE Stage: Study Selection Study Proposal Selection Criteria Prioritized into Pipeline Stage: Design & Planning Data Design Participating Entities Planning Logistics Stage: Execution & Analysis Moderated Exchange Aggregation & Results Analysis Corroboration Iteration Stage: Outcomes Measurement Process & Operational Outcomes

10. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. DARC STUDY PIPELINE AND OVERLAP WITH CONCEPTUAL STUDY LIFE CYCLE Stage: Study Selection Study Proposal Selection Criteria Prioritized into Pipeline Stage: Design & Planning Data Design Participating Entities Planning Logistics Stage: Execution & Analysis Moderated Exchange Aggregation & Results Analysis Corroboration Iteration Stage: Outcomes Measurement Process & Operational Outcomes Pipeline Tiger Team will: Document Study Concepts; Prioritize Concepts; Recommend Studies.

11. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. DARC - STUDY PIPELINE AND OVERLAP WITH CONCEPTUAL STUDY LIFE CYCLE Stage: Study Selection Study Proposal Selection Criteria Prioritized into Pipeline Stage: Design & Planning Data Design Participating Entities Planning Logistics Stage: Execution & Analysis Moderated Exchange Aggregation & Results Analysis Corroboration Iteration Stage: Outcomes Measurement Process & Operational Outcomes Pipeline Tiger Team will: Coordinate Intended Study Concepts with Technical Sub Groups

12. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. EARLY ACTIVITIES OF THE PARTNERSHIP The first information exchange has occurred (more information discussed on the next slide). Sharing this information is considered a major milestone in the maturation of the HFPP and tested the process for data exchange Participating partners are evaluating the results for use and value in their individual programs Participating partners were limited due to legal constraints

13. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. FIRST INFORMATION EXCHANGE 11 Partners Contributed 2 Federal 1 State 1 Private Association 7 Private Payers 3 Information Types >1400 Misused Codes >100 Fraud Schemes >44 Data Sources Partner analysis yielded various interesting findings First Information Exchange Misused Codes Fraud Schemes Data Sources

14. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. EXAMPLES OF SHARED INFORMATION: MISUSED CODES & FRAUD SCHEMES

15. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. THE FUTURE OF THE PARTNERSHIP Build the Trusted Third Party & necessary technical capabilities Active pipeline of studies & data exchanges Legal agreements and other necessary policies Identifiable data exchanges Best practices and information sharing Expanded membership & fraud-fighting capabilities

16. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. DATA SHARING OPERATIONAL MILESTONES CY ‘13 Q1CY ‘13 Q3CY ‘13 Q2CY ‘13 Q4 De-Identified Information Sharing (i.e. Best Practices, Fraud Schemes) Proof of Concept for Identified Information Exchange Data Sharing Business Framework Technical Framework Launch Trusted Third Party Develop Trusted Third Party Strategy Leverage Interim Trusted Third Party Technical Prototyping Fully established framework for identified information exchange CMS Business Framework CMS Delegation of Authority – Authority for CMS to exchange information with private partners CMS System of Record Notice – Requirement for aligning CMS systems with data exchange needs  CMS Umbrella Paperwork Reduction Act Clearance – Permits expansion beyond 9 private participating entities CMS Business Framework CMS Delegation of Authority – Authority for CMS to exchange information with private partners CMS System of Record Notice – Requirement for aligning CMS systems with data exchange needs  CMS Umbrella Paperwork Reduction Act Clearance – Permits expansion beyond 9 private participating entities Partner and Participating Entity Framework Memoranda of Understanding – Establishes principles of the partnership  Business Associate Agreements – Legal agreements to allow sharing of identified data Partner and Participating Entity Framework Memoranda of Understanding – Establishes principles of the partnership  Business Associate Agreements – Legal agreements to allow sharing of identified data

17. For Limited Distribution The following disclaimer applies: Regarding all Healthcare Fraud Prevention Partnership communications and activities, this is a purely voluntary activity. The committees regarding data sharing and analysis; information sharing; and the Executive Board, are to be used solely as discussion groups where the individual members can share facts or information or individual input. No group or consensus advice or recommendations will be given by the partners in the committees or the Executive Board. In addition, no policy-making or decision-making will be performed by the committees or the Executive Board. The Secretary and the Attorney General or their designees will make the final policies or other decisions. Questions Questions? Please enter questions into the Question or Chat pods in the GoToMeeting webinar interface or please send us an email at: MEDIC-Outreach@RainmakersSolutions.com ?