Agenda 2015

Agenda 2015

CONFERENCE AGENDA

Sunday, August 9, 2015

8:00 am – 4:00 pm

Exhibit Hall Set Up

 Acadia, Third Floor

12:00 – 6:30 pm

Registration and Information

 Acadia Foyer, Third Floor

2:30 – 2:45 pm

Opening Session / Welcome by NAMPI Board

John F. McCormick, CT, NAMPI President

Jacqueline Thomas, AL, NAMPI Vice President

Lori Stiles, ID, NAMPI Treasurer

Otis Washington, Jr., MS, NAMPI Secretary

Alan S. White, WI, NAMPI Chair, Regional Representatives

Joan Senatore, MA, NAMPI Past President

 Carondelet, Third Floor

2:45 – 4:00 pm

State Only Regional Round Table

Moderator: Alan S. White, WI, NAMPI Chair, Regional Representatives

 Carondelet, Third Floor

4:00 – 5:00 pm

Navigating the Data Intersection of Commercial Plans and Government Funded Programs

Speaker: Ricky Sluder, CFE, SAS Security Intelligence Practice

Studios 2 – 4, Second Floor

4:00 – 5:00 pm

A Medicaid Director’s View of Program Integrity in Managed Care

Speakers: Jerry Dubberly, PharmD, Myers and Stauffer; Toni Prine, RPh, Myers and Stauffer

 Studios 7 – 9, Second Floor

4:00 – 5:00 pm

Medicaid Fraud/Abuse & Prepay:  A North Carolina Success Story

Speakers: Alexandria Denton, The Carolinas Center for Medical Excellence; Ed Rounds, IBM

 La Galleries 4 – 5, Second Floor

5:30 – 7:30 pm

Exhibit Hall Opening Reception
Sponsored by Optum

 Acadia, Third Floor

CONFERENCE AGENDA

Monday, August 10, 2015

7:30 am – 4:30 pm

Registration and Information

 Acadia Foyer, Third Floor

7:30 – 8:45 am

Breakfast

 Bissonet, Third Floor

8:00 am – 4:30 pm

Exhibit Hall

 Acadia, Third Floor

8:45 – 9:00 am

Opening Remarks / Welcome Address

John F. McCormick, CT, NAMPI President

 Carondelet, Third Floor

9:00 – 10:00 am

Keynote Address

Sponsored by LexisNexis

Speaker: Elizabeth Smart

Introduction by: Doug Tomlin, LexisNexis

 Carondelet, Third Floor

10:00 – 11:00 am

CMS Program Integrity Activities and Future Direction

Speaker: Jonathan Morse, CMS, Center for Program Integrity

Moderator: Joan Senatore, MA, NAMPI Past President

 Carondelet, Third Floor

11:00 – 11:30 am

Networking Break

 Exhibit Hall

11:30 am – 12:30 pm

Working With Your MFCU

Panelists: Mykel Fry, OK; Margaret O’Connell, AR; Kelly Shropshire, OK

Moderator: Mark Gaskill, WY

 Studios 2 – 4, Second Floor

11:30 am – 12:30 pm

Successful Algorithms

Speakers: Veronica Judy Cecil, KY; Carl Ishmael, KY

Moderator: Leanne Miles, VT

 Studios 7 – 9, Second Floor

11:30 am – 12:30 pm

Oversight of Home & Community Based Waivers

Panelists: Stephanie Blocker, RN, AR; Bradley K. Hart, IL;  

Robin Raveendran, Preferred Family Healthcare

Moderator: Bernadette Parks, MS

 La Galleries 4 – 5, Second Floor

12:30 – 1:30 pm

Lunch

 Bissonet, Third Floor

1:30 – 2:30 pm

GAO Report on Program Integrity

Speaker: Carolyn Yocom, US Government Accountability Office

Moderator: Jacqueline Thomas, AL, NAMPI Vice-President

 Carondelet, Third Floor

2:30 – 2:40 pm

Break

2:40 – 3:40 pm

Expand the Impact of Your PI Unit – and Get Credit for it

Speakers: Brian Fisher, Optum; Jeremy Hill, Optum

 Studios 2 – 4, Second Floor

2:40 – 3:40 pm

Addressing the Challenges of the Paradigm Shift: 

Pre-Payment and Managed Care Analytics

Panelists: Clint R. Eisenhower, PA;

Brien Lorenze, Deloitte Transactions and Business Analytics LLP;

Dan Olson, CFE, Deloitte Transactions and Business Analytics LLP;

Dong Siegel, Deloitte Transactions and Business Analytics

 Studios 7 – 9, Second Floor

2:40 – 3:40 pm

Effective Member Integrity: How the Use of Enhanced, Continuous Eligibility Verification and Risk Scoring Can Reduce Costs and Improve Service Delivery

Speaker: Clint Fuhrman, MAXIMUS

 La Galleries 4 – 5, Second Floor

3:40 – 4:00 pm

Networking Break

 Exhibit Hall

4:00 – 5:00 pm

Provider Enrollment & Screening

Panelists: Erica Brooks, NE; Zabeen Chong, CMS, Center for Program Integrity;

Jessica Dresner, MO; Charles Schalm, CMS, Center for Program Integrity

Moderator: Anne Harvey, NE

 Studios 2 – 4, Second Floor

4:00 – 5:00 pm

Case Studies – Dental, DME & Pharmacy

Panelists: Bob Dwyer, DDS, WI; Steve Short, VT; Kenneth Yon, FL

Moderator: Kiva Gittings Graves, WI

 Studios 7 – 9, Second Floor

4:00 – 5:00 pm

ROI – Facts & Myths

Speakers: Bradley K. Hart, IL; Cindy Roberts, OK

Moderator: Jane Oliver-Vaeth, MD

 La Galleries 4 – 5, Second Floor

6:00 – 9:00 pm

NAMPI Reception at Mardi Gras World

Sponsored by HMS

 1380 Port of New Orleans Place

Shuttles will depart from the Canal entrance of the New Orleans Marriott starting at 5:45 pm.  The last shuttle will depart at 6:15 pm.

CONFERENCE AGENDA

Tuesday, August 11, 2015

8:00 am – 4:30 pm

Registration and Information

Acadia Foyer, Third Floor

8:00 – 8:45 am

Breakfast

 Bissonet, Third Floor

8:00 am – 4:30 pm

Exhibit Hall

 Acadia, Third Floor

8:45 – 9:00 am

Business Meeting, Election of Officers
John F. McCormick, CT, NAMPI President

 Carondelet, Third Floor

9:00 – 10:00 am

Medicaid Integrity Institute Update

Speaker: Tom Falkinburg, Medicaid Integrity Institute

Moderator: Alan S. White, WI, NAMPI Chair, Regional Representatives

 Carondelet, Third Floor

10:00 – 10:10 am

Break

10:10 – 11:10 am

Composition of PI Unit

Panelists: Daphne Enfinger, TN; Dawn Frazier, RN, BSN, CLNC, CPC, CPIP, TN;

Kelly Shropshire, OK

Moderator: Mindy Chavanelle, NH

 Studios 2 – 4, Second Floor

10:10 – 11:10 am

Advanced Analytics

Panelists: Bradley K. Hart, IL; Sharon Ormsby, AZ; Cathie Ott, WA

Moderator: Betsy Genz, WI

 Studios 7 – 9, Second Floor

10:10 – 11:10 am

What to Expect During a PERM Review & Next Steps For PERM Eligibility

Speakers: Cindy Howe, CMS, Division of Error Rate Measurement;

Tracy Smith, CMS, Division of Error Rate Measurement

Moderator: Stacey Krometis, CMS, Division of Error Rate Measurement

 La Galleries 4 – 5, Second Floor

11:10 – 11:30 am

Networking Break

 Exhibit Hall

11:30 am – 12:30 pm

Future Fraud Busters: How Integrating Clinical and Claims Platforms, and Applying New Predictive Models to Behavioral Health Will Change the Industry

Speakers: Geetu Melwani, HMS; Spencer Young, HMS

 Studios 2 – 4, Second Floor

11:30 am – 12:30 pm

The Next Generation of Medicaid Program Integrity:

Where Identity Data, Linking Technology, And Clearinghouses Intersect

Speaker: Richard K. Grape, Jr., MPA, MCMP-II, LexisNexis

 Studios 7 – 9, Second Floor

11:30 am – 12:30 pm

From RFP to Go Live:

Discover the Software Development Lifecycle of a FWA Analytics System

Panelists: Garret Biemer, BAE Systems Applied Intelligence; Bruce McIntyre, RI;

Joan Senatore, MA

Moderator: Richard Graham, BAE Systems Applied Intelligence

 La Galleries 4 – 5, Second Floor

12:30 – 1:30 pm

Lunch / Exhibit Booth Giveaways

 Bissonet, Third Floor

1:30 – 2:30 pm

Oversight of Managed Care

Panelists: Kelly Bennett, JD, CFE, FL; Dennis J. Garvey, JD, TN; Michael McCoy, NJ

Moderator: Joan Senatore, MA, NAMPI Past President

 Carondelet, Third Floor

2:30 – 2:40 pm

Break

2:40 – 3:40 pm

Payment Suspension

Speakers: Dennis J. Garvey, JD, TN; Doug Jones, AK

Moderator: MaryKay Cary, NJ

 Studios 2 – 4, Second Floor

2:40 – 3:40 pm

Behavioral Health

Panelists: Janet Bacon, CT; Demetrese Evans, MS;  Bernadette Parks, MBA, CPIP, MS

Moderator: Kieu Pham, CO

 Studios 7 – 9, Second Floor

2:40 – 3:40 pm

Challenges Presented by New Drugs

Speaker: Mike Cohen, US Dept. of HHS, OIG, Office of Investigations

Moderator: Kristin Edwards, OK

 La Galleries 4 – 5, Second Floor

3:40 – 4:00 pm

Networking Break

 Exhibit Hall

4:00 – 5:00 pm

Addressing Evolving Threats in Fraud, Waste and Abuse:

Missouri Medicaid Audit and Compliance and Truven Health Analytics

Panelists: Jessica Dresner, MO; Mark Gillespie, Truven Health Analytics;

David Hart, Truven Health Analytics; David Nelson, Truven Health Analytics

 Studios 2 – 4, Second Floor

4:00 – 5:00 pm

Cost Avoidance is the New Recoupment:

How Medicaid Agencies Can Keep More of Their Dollars

Speakers: Thomas Aldridge, Public Consulting Group;

Dale McCourt, Public Consulting Group; Jay Peck, Public Consulting Group

 Studios 7 – 9, Second Floor

4:00 – 5:00 pm

High-Performing State Medicaid Integrity Programs:

Putting It All Together In The “Final Mile”

Panelists: Lauren Calabria, KPMG; Clint Eisenhower, PA; Bruce Lim, CPA, CA;

Denise Poley, KPMG

 La Galleries 4 – 5, Second Floor

5:30 – 7:30 pm

Networking Event at the Napoleon House

Sponsored by Deloitte

 500 Chartres Street

The Napoleon House is a short 7-minute walk from the New Orleans Marriott.

CONFERENCE AGENDA

Wednesday, August 12, 2015

7:30 am – 1:00 pm

Registration and Information

Acadia Foyer, Third Floor

7:30 – 8:15 am

Breakfast

Bissonet, Third Floor

8:15 – 8:20 am

Daily Remarks

John F. McCormick, CT, NAMPI President

Carondelet, Third Floor

8:20 – 9:20 am

CMS Center for Program Integrity Q&A with States

Speakers: Peter Leonis, CMS, Center for Program Integrity;

Mark Majestic, CMS, Center for Program Integrity

Moderator: Lori Stiles, ID, NAMPI Treasurer

Carondelet, Third Floor

9:20 – 10:20 am

National Health Care Fraud Trends

Speaker: Jennifer Trussell, US Dept. of HHS, OIG, Office of Investigations

Moderator: Otis Washington, Jr., MS, NAMPI Secretary

Carondelet, Third Floor

10:20 – 10:30 am

Break

10:30 – 11:30 am

National Association of Medicaid Fraud Control Units (NAMFCU) Update

Speaker: Bruce M. Lieberman, National Association of Medicaid Fraud Control Units

Moderator: John F. McCormick, CT, NAMPI President

Carondelet, Third Floor

11:30 am – 12:30 pm

Open Forum with NAMPI Board

Moderator: John F. McCormick, CT, NAMPI President

 Carondelet, Third Floor

 

12:30 – 12:45 pm

Closing Session

Computer Give Away

Free Registration for 2016 Conference Give Away

Announcement from 2016 Host State

Moderator: John F. McCormick, CT, NAMPI President

Carondelet, Third Floor

12:30 – 1:00 pm

Boxed Lunch

Acadia Foyer, Third Floor