Agenda 2014

Agenda 2014

Below you will find the NAMPI 2014 Annual Conference agenda. Session titles that are underlined have presentations linked to them. To view the presentation, please click on the corresponding session title. Presentations have been published with permission of the session's speaker.

Sunday, August 3, 2014

9:00 - 11:00 AM

Exhibit Hall Set Up

Lone Star Salon A-B and Foyer, Level Two

12:00 - 6:30 PM

Registration and Information

Level Two, Foyer

3:00 - 4:00 PM

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

Lone Star Salon C, Level Two

4:00 - 4:30 PM

Opening Session/Welcome by NAMPI Board
Joan Senatore, MA, NAMPI President
John F. McCormick, CT, NAMPI Vice-President
Lori Stiles, ID, NAMPI Treasurer
Jacqueline Thomas, AL, NAMPI Secretary
Alan S. White, WI, NAMPI Chair, Regional Representatives

Lone Star Salon D-F, Level Two

4:30 - 6:30 PM

Exhibit Hall Opening Reception
Sponsored by Optum

Lone Star Salon A-B and Foyer, Level Two

7:30 - 9:30 PM

Kick-Off Celebration at the Chart House
Sponsored by 21CT

739 E Cesar E Chavez Blvd.
Shuttles will depart from the Market St. entrance at the
Grand Hyatt starting at 7:15 pm. The last shuttle will depart at 7:45 pm.

Monday, August 4, 2014

 7:15 AM - 4:30 PM

Registration and Information

Level Two, Foyer

7:15 - 8:00 AM

Breakfast

Lone Star Ballroom Corridor and Salon C, Level Two

7:15 AM - 4:30 PM

Exhibit Hall

Lone Star Salon A-B and Foyer, Level Two

8:00 - 8:30 AM

Opening Remarks/Welcome Address
Joan Senatore, MA, NAMPI President

Lone Star Salon D-F, Level Two

 8:30 - 9:30 AM

Keynote Address
Sponsored by LexisNexis
Speaker: Sean Tuohy
Moderator: Kevin McCabe, LexisNexis

Lone Star Salon D-F, Level Two

 9:30 - 10:00 AM

Networking Break

Exhibit Hall

10:00 - 11:00 AM 

 Bending the Cost Curve at CMS
Speaker: Shantanu Agrawal, MD, CMS, Center for Program Integrity
Moderator: Jacqueline Thomas, AL, NAMPI Secretary

Lone Star Salon D-F, Level Two

11:00 - 11:15 AM

Break

Track 1: Focus: State - Texas Salon A, Level Four

Track 2: Focus: Audit/Fraud - Texas Salon B, Level Four

Track 3: Focus: Federal - Texas Salon C, Level Four

Track 4: Vendor 1 - Travis A-B, Level Three

Track 5: Vendor 2 - Travis C-D, Level Three

11:15 AM - 12:15 PM

Detecting and Preventing Fraud and Abuse in
Managed Care Organizations
Panel: Dennis J. Garvey, JD, TN; Sharon Ormsby, AZ

Moderator: Valerie Sobotta, WI

Texas Salon A, Level Four

11:15 AM - 12:15 PM

KASPER and Prescription Drug Monitoring Programs
Speaker: Stephanie Hold, KY
Moderator: Carl Ishmael, KY

Texas Salon B, Level Four

11:15 AM - 12:15 PM

Statistically Valid, Legally Defensible Program Integrity Sampling
Speaker: Bruce E. Truitt

Moderator: Rocco Russo Jr., IA

Texas Salon C, Level Four

11:15 AM - 12:15 PM

Aggregated Data Analytics: Trends, Pitfalls, and
Opportunities for Payers
Speakers: Mike Hostetler, HMS; Dan Olson, CFE, HMS

Travis A-B, Level Three

11:15 AM - 12:15 PM

Medicaid Program Integrity for Benefit Exchanges:
CMS Requirements
Speakers: Rory Costello, KPMG, LLP; Jason Ganns, KPMG, LLP

Travis C-D, Level Three

 12:15 - 1:15 PM

Lunch

Lone Star Ballroom Corridor and Salon C, Level Two

1:15 - 2:15 PM

Biggern' Texas – Use of Data Analytics to Increase
Overutilization Identification

Speakers: Douglas C. Wilson, CIG, CPA TX; Hon. Jack Stick, TX
Moderator: John F. McCormick, CT, NAMPI Vice President

Lone Star Salon D-F, Level Two

2:15 - 2:30 PM

Break

 2:30 - 3:30 PM

Private MCO SIUs
Speaker: Mary Beach, WellPoint

Moderator: Dawn Frazier, TN

Texas Salon A, Level Four

  2:30 - 3:30 PM

Using Algorithms
Panel: Veronica Judy Cecil, KY; Carl Ishmael, KY

Moderator: Bruce E. Truitt

Texas Salon B, Level Four

2:30 - 3:30 PM

PARIS/Veteran Benefit Enhancement
Speaker: Bill Allman, WA; Veronica Gonzalez, US Dept. of HHS, OIG,
Office of
Evaluation and Inspections

Moderator: Sheila McInerney, WY

Texas Salon C, Level Four

2:30 - 3:30 PM

The Truth About Identity-Based Fraud and Why it
Matters to Medicaid
Speakers: Alisoun Moore, LexisNexis; Bo Nowell, LexisNexis

Travis A-B, Level Three

2:30 - 3:30 PM

RAC'ing Up Recoveries: How Georgia is Partering with its RAC
to Recover Millions and Enhanced PI
Speakers: Robert M. Finlayson III, GA; Michael D. Johnson, CPA, CFE,
Myers and Stauffer, LC; Scott A. Smeal, Myers and Stauffer, LC

Travis C-D, Level Three

3:30 - 4:00 PM

Networking Break

Exhibit Hall

 4:00 - 5:00 PM

ACA Screening Levels
Speakers: Erica Brooks, NE; Jill M. Santos, TX
Moderator: Anne Harvey, NE

Texas Salon A, Level Four

 4:00 - 5:00 PM

Your TPL Contract
Speakers: MaryKay Cary, RN, BSN, NJ; Michael A. McCoy, NJ
Moderator: James Waddick, IN

Texas Salon B, Level Four

4:00 - 5:00 PM

PERM Eligibility Pilot Reviews
Speakers: Chrissy Fowler, CMS, Division of Error Rate Measurement;
Stacey Krometis, CMS, Division of Error Rate Measurement

Texas Salon C, Level Four

4:00 - 5:00 PM

Leveraging Data Visualization to Improve Program Integrity Outcomes
Speaker: Craigan Gray, MD, JD, MBA, CPE, Salient Corporation

Travis A-B, Level Three

4:00 - 5:00 PM

Know Your Provider
Speaker: Rohit Agarwal, Digital Harbor

Travis C-D, Level Three

6:00 - 9:00 PM

NAMPI Gala at the Buckhorn Saloon
Sponsored by HMS

318 E Houston St.
Shuttles will depart from the Market St. entrance at the
Grand Hyatt starting at 5:45 pm. The last shuttle will depart at 6:15 pm.

Tuesday, August 5, 2014

 7:15 AM - 4:30 PM

Registration and Information

Level Two, Foyer

7:15 - 8:00 AM

Breakfast

Lone Star Ballroom Corridor and Salon C, Level Two

7:15 AM - 4:30 PM

Exhibit Hall

Lone Star Salon A-B and Foyer, Level Two

8:00 - 8:30 AM

Business Meeting, Election of Officers
Joan Senatore, MA, NAMPI President

Lone Star Salon D-F, Level Two

 8:30 - 9:30 AM

FY-14 Accomplishments, FY-15+ Goals
Speaker: Cam Towers Jones, MII, Office of Legal Education,
US Dept. of Justice

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

Lone Star Salon D-F, Level Two

 9:30 - 9:50 AM

Networking Break

Exhibit Hall

 9:50 - 10:50 AM

National Trends in Medicaid: A Medicaid Director's View
Speaker: Andrea Maresca, National Association of Medicaid Directors
Moderator: Lori Stiles, ID, NAMPI Treasurer

Lone Star Salon D-F, Level Two

10:50 - 11:00 AM

Break

11:00 AM - 12:00 PM

TAG Provider Screening & Enrollment Workgroup
Speakers:
Ron Clark, VT; Marta Stagliano, NV
Moderator: Jane Oliver-Vaeth, MD

Texas Salon A, Level Four

11:00 AM - 12:00 PM

Behavioral Health Investigations - Connecticut's Perspective
Speaker: Janet Bacon, CT

Moderator: Lynwood Patrick, CT

Texas Salon B, Level Four

11:00 AM - 12:00 PM

PERM Process Overview
Speakers: Wendy Chesser, CMS, Division of Error Rate Measurement;
Stacey Krometis, CMS, Division of Error Rate Measurement

Texas Salon C, Level Four

11:00 AM - 12:00 PM

Solving the Fraud Detection Analytics Puzzle: People + Technology
Speaker: Ross Worden, CFE, 21CT

Travis A-B, Level Three 

11:00 AM - 12:00 PM

A Big Data Approach for Medicaid Program Integrity:
Using External Data and Visualization to Achieve Better
Results from Predictive Analytics
Speaker: Jeremy Hill, Optum

Travis C-D, Level Three

 12:00 - 1:00 PM

Lunch/ Announcement of Officers/ Exhibit Booth Giveaways

Lone Star Ballroom Corridor and Salon C, Level Two

1:00 - 2:00 PM

ACA Fingerprinting and Background Checks
Speakers: Jessica Dresner, MO; Robert M. Finlayson III, GA

Moderator: Julie Beck, MN

Texas Salon A, Level Four

1:00 - 2:00 PM

Dental Case Reviews
Speaker: Bob Dwyer, DDS, WI

Moderator: Betsy Genz, WI

Texas Salon B, Level Four

1:00 - 2:00 PM

Medicare-Medicaid (Medi-Medi) Data Match Program
Panel: Daphne Enfinger, TN; Brian Klozik, TX; Cathie Ott, WA
Cindy Sisti, CFE, CMS, Center for Program Integrity
;
Otis Washington, Jr., MS

Moderator: Robin Raveendran

Texas Salon C, Level Four

1:00 - 2:00 PM

Addressing Evolving Threats in Fraud, Waste and Abuse
Speakers: Mark Gillespie, Truven Health Analytics; Jean MacQuarrie,
Truven Health Analytics; David Nelson, Truven Health Analytics

Travis A-B, Level Three

1:00 - 2:00 PM

Program Integrity in a Growing Medicaid Population Moving
From FFS to Managed Care: Are You Ready?
Speakers: Lea Carino, Xerox; Sara Fitzsimmons, Xerox

Travis C-D, Level Three

2:00 - 2:10 PM

Break

2:10 - 3:10 PM

Overview of OIG Medicaid Program Integrity Work
Speaker: Jonathan Jones, US Dept. of HHS, OIG, Office
of Evaluation and Inspections
;
Ann Maxwell, US Dept. of HHS, OIG, Office
of Evaluation and Inspections

Moderator: Leanne Miles, VT

Texas Salon A, Level Four

2:10 - 3:10 PM

ACA State Experiences with Suspended Payments
Panel: Dennis J. Garvey, JD, TN; Douglas Jones, AK;
Bruce Lim, CA; Karen Pettigrew, TX

Moderator: Sharon Ormsby, AZ

Lone Star Salon D-F, Level Two

2:10 - 3:10 PM

Medicare Provider Enrollment -
Medicare Revocations and Medicaid Terminations
Speaker: Charles Schalm, CMS,  Program Integrity Enforcement Group
Moderator: Mindy Chavanelle, NH

Texas Salon C, Level Four

2:10 - 3:10 PM

Promoting Program Integrity by Leveraging Integrated
Pharmacy & Medical Data
Speakers: Victor J. Haddock, Magellan Health;
Patricia Hoofnagle, AHFI, Magellan Health;
William Mesaros, Magellan Health

Travis A-B, Level Three

2:10 - 3:10 PM

From Data to Savings - Anatomy of a Pre-Pay Detection
Speaker: Garrett Biemer, BAE Systems Applied Intelligence

Travis C-D, Level Three

2:10 - 3:10 PM

Best Practices for Accurately Determining and Verifying Eligibility
Speakers: Joe Dupelle, MAXIMUS; Josh Ruminski, MAXIMUS;
Irene Zhou, MAXIMUS

Texas Salon B, Level Four

3:10 - 3:30 PM

Networking Break

Exhibit Hall

3:30 - 4:30 PM

RAC Best Practices
Panel: Carl Ishmael, KY; Lalita Jambhale, MD, OH; Otis Washigton, Jr., MS
Moderator: Amy Guimond, WY

Texas Salon A, Level Four

3:30 - 4:30 PM

The Structure of a Program Integrity Unit
Panel: Jessica Dresner, MO; Robert M. Finlayson, III, GA;
Martin Thies, PhD, CIA, WA
Moderator: Bradley Hart, IL

Texas Salon B, Level Four

3:30 - 4:30 PM

Predictive Analytics
Speaker: Raymond L. Wedgeworth, CMS, Data Analytics and Control Group
Moderator: Donna Kellow, CO

Texas Salon C, Level Four

3:30 - 4:30 PM

Enterprise Fraud Management: Application to
Medicaid Fraud Analytics
Speakers: Sriram Krishnan, Deloitte Financial Advisory Services;
Mike Little, Deloitte Financial Advisory Services;
Dong Siegel, Deloitte Financial Advisory Services

Travis A-B, Level Three

3:30 - 4:30 PM

Health Integrity's Approach to Hospice Issues
Speakers: David Duhaime, Health Integrity, LLC;
Jaysen Eisengrein, Health Integrity, LLC

Travis C-D, Level Three

5:30 - 7:30 PM

Happy Hour at The Worm Tequila & Mezcal Bar
Sponsored by Deloitte

123 Losoya St.
Water taxis will depart from the Grand Hyatt at 5:30 pm and 5:45 pm.

Wednesday, August 6, 2014

7:15 AM - 1:00 PM

Registration and Information

Level Two, Foyer

7:15 - 8:00 AM

Breakfast

Lone Star Ballroom Corridor and Salon C, Level Two

8:00 - 8:15 AM

Daily Remarks
Joan Senatore, MA, NAMPI President

Lone Star Salon D-F, Level Two

8:15 - 9:15 AM

Advanced Analytics in State Medicaid Programs
Speakers: John F. McCormick, CT, NAMPI Vice President;
Jennifer Stansbury, TX; Cathie Ott, WA

Moderator: Kelly Shropshire, OK

Lone Star Salon D-F, Level Two

 9:15 - 10:15 AM

State Medicaid Fraud Enforcement Efforts
Speaker: D. Mark Collins, Past President, National Association of Medicaid
Fraud Control Units

Moderator: Joan Senatore, MA, NAMPI President

Lone Star Salon D-F, Level Two

10:15 - 10:30 AM

Break

10:30 - 11:30 AM

Health Care Fraud Trends from the OIG
Speaker: Cynthia Pangallo, US Dept. of HHS, OIG, Office of Investigations
Moderator: Lori Stiles, ID, NAMPI Treasurer

Lone Star Salon D-F, Level Two

11:30 AM - 12:30 PM

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

Lone Star Salon D-F, Level Two

12:30 - 1:00 PM

Closing Session
Computer Give Away

Free Registration for 2015 Give Away
Welcome from 2015 Host State
John F. McCormick, CT, NAMPI Incoming President

Lone Star Salon D-F, Level Two

12:30 - 1:00 PM

Boxed Lunch

Lone Star Ballroom Corridor and Salon C, Level Two