2018 Presentations

2018 Presentations

View or Download the 2018 Agenda here*

Sunday, August 26, 2018

Jolene Guignet - Beneficiary Fraud: Strategies for Ensuring Program Integrity

Tim Helms, Andrew Linn - Using Risk Models and Data Visualizations in Investigations

Max Garner, Jarrod Webb - Highlighting Tennessee's MCO Oversight and Program Integrity Tools and Relationships

Kathy Haley, Michael Johnson - Don't Set It and Forget It: 5 Tips to Maintaining Oversight of Your MCO

Robert Finlayson, Jason Helmandollar, Mallika Thanky - New Tools for Your Greatest FWA Hits: Inpatient Overlap, Ambulance Phantom Runs and Impossible Days


Monday, August 27, 2018

Joanne Chiedi - HHS Office of the Inspector General - Observations on Program Integrity

Pamela Mailey - Managed Care Network Provider Reviews 

Cherie Couts, Kristi Erlewine - Examining Behavioral Health Services – A Medicaid Perspective 

Katherine M Leff, Nicholas Messuri, Rick Munson - Medicaid Managed Care: Challenges and Opportunities of Investigating Medicaid Fraud

Tim Hill - The Opioid Crisis:  Medicaid Steps Up 

Joseph Cassano, Anthony Monaco, Michael Pappas - A Deeper Dive into MCO Oversight Analytics and Compliance: National Insights on a Comprehensive Program Integrity Approach

Jay Peck, Jon Riley - Casting Light on Appeals: Is Your Appeals Process Costing You Big Money?

Amanda Huston, Richard B Knight, Dwight Osteen - “If I Did It”: Medical Professionals Speak Frankly About the Vulnerabilities in the Medicaid System

George Mathew, Brian Steele - Opioid Crisis and Analytics


Tuesday, August 28, 2018

Quinton Arnold, Lisa Pietrzyk, Deborah Wray, Robin Zennon, - Electronic Visit Verification (EVV)  Community Attendant Services (CAS) inspection results

Dale Carr, Greg Lakin, Pamela Mailey - State Responses to the Opioid Crisis 

Brett Hayes,  Elizabeth Thomas Smith - Attacking Vulnerabilities in Personal Care Services 

Charles Grant - Medicare and Medicaid Exclusions 

Fernando Alvarez, Michael Hall, Matt Harris, Dan Olson - Maturing Pre- and Post-Pay Intervention Strategies Using Advanced Analytics

Drew Gattine, Maureen Lindberg - Cost Avoidance Strategies to Drive Value from Data Analytics

Scott Weinberg - Forensic Accounting in Managed Care 

Carl Ishmael - Auditing and Recovering Managed Care Encounters

Danielle Foley - A Framework for Setting up a Program Integrity Return on Investment Project 

Asad Salahuddin - First Data authenticare® - Electronic Visit Verification for State Agencies and Managed Care Organizations

Justin Hyde - Eligibility Alone Can’t Prevent Healthcare Fraud; Why Identity Assessment Should be the First Step for Success


Wednesday, August 29, 2018

Alec Alexander - CMS Center for Program Integrity: Initiatives and Priorities

Michael Cimmino, Brenda Mullens - Updates from the Center for Program Integrity, Provider Enrollment & Oversight Group

Laurie Battaglia, Elizabeth Lindner, Joy Sparks - Updates from the Center for Program Integrity Investigations and Audits Group