NAMPI 2016 Agenda and Presentations

NAMPI 2016 Agenda and Presentations

Agenda subject to change. All NAMPI programming takes place on the third and fourth floors of the Baltimore Marriott Waterfront.

CONFERENCE AGENDA

Sunday, August 28, 2016

8:00 am – 4:00 pm

Exhibit Hall Set Up

 Grand Ballroom V & Foyer

12:00 – 6:30 pm

Registration & Information

 Grand Ballroom Foyer

2:00 – 2:15 pm

Opening Session

Welcome by NAMPI Board

Regional Representative Introductions

John F. McCormick, CPA, Connecticut Dept. of Social Services, NAMPI President

Jacqueline Thomas, Alabama Medicaid Agency, NAMPI Vice President/President Elect

Lori Stiles, Idaho Dept. of Health & Welfare, NAMPI Treasurer

Otis Washington, Jr., Mississippi Division of Medicaid, NAMPI Secretary

Joan Senatore, JD, MBA, CFE, CCH, Massachusetts Executive Office of HHS, NAMPI Past President

 MaryKay Cary, New Jersey Office of the State Comptroller, Chair, Regional Representatives

Harborside A-C

2:15 – 3:00 pm

Medicaid Program Integrity Overview

Speaker: Jonathan Morse, JD, Center for Program Integrity, CMS

Moderator: Joan Senatore, JD, MBA, CFE, CCH, Massachusetts Executive Office of HHS, NAMPI Past President

 Harborside A-C

3:00 – 3:30 pm

State Liaison Staff (SLS) Collaborative Activities With States

Speaker: Clint Eisenhower, CMS, Center for Program Integrity

Moderator: MaryKay Cary, New Jersey Office of the State Comptroller, Chair, Regional Representatives

Harborside A-C

3:30 – 4:30 pm

Health Care Transformation and the Changing Tides of Medicaid Program Integrity

Speaker: Jerry Dubberly, PharmD, Myers and Stauffer

Panelists: Kimberly Forrest, RHIA, Myers and Stauffer;

Toni Prine, RPh, CPC, Myers and Stauffer;

Bill Root, Myers and Stauffer

 Grand Ballroom I-IV

3:30 – 4:30 pm

Third Party Liability and Cost Avoidance Solutions

Speaker: Steve Konsin, RPh, Syrtis Solutions

Dover A-C

5:00 – 6:30 pm

Exhibit Hall Opening Reception

Grand Ballroom V & Foyer

CONFERENCE AGENDA

Monday, August 29, 2016

7:30 am – 4:30 pm

Registration & Information

Grand Ballroom Foyer

7:30 – 8:30 am

Breakfast

Grand Ballroom VI

8:00 am – 4:30 pm

Exhibit Hall

Grand Ballroom V & Foyer

8:30 – 8:45 am

Opening Remarks / Welcome Address

John F. McCormick, Connecticut Department of Social Services, NAMPI President

Harborside A-C

8:45 – 9:30 am

Keynote Address

Sponsored by LexisNexis Risk Solutions

Speaker: Jim Abbott

Introduction by: Doug Tomlin, LexisNexis Risk Solutions

Harborside A-C

9:30 – 10:30 am

National Health Care Fraud Trends

Speaker: Jennifer Trussell, US Dept. of HHS, Office of Inspector General

Moderator: Otis Washington, Jr., Mississippi Division of Medicaid, NAMPI Secretary

Harborside A-C

10:30 – 11:00 am

Networking Break

Grand Ballroom V & Foyer

11:00 am – 12:00 pm

Successful Algorithms, Part III

Speakers: Carl Ishmael, Commonwealth of KY, Cabinet for Health & Family Services;

Wm. Robert Long, Jr., Commonwealth of KY, Cabinet for Health & Family Services

Moderator: Susan Selby, Commonwealth of KY, Cabinet for Health & Family Services

Grand Ballroom I-IV

11:00 am – 12:00 pm

Provider Enrollment Compliance Update with Emphasis on FCBC

Speaker: Jennifer Bean, CMS

Moderator: Jane Oliver-Vaeth, MD

Grand Ballroom VII-X

11:00 am – 12:00 pm

Indiana’s Program Integrity Best Practices

Speakers: Scott Gartenman, Indiana Family & Social Services Administration;

 Becky Selig, Indiana Family & Social Services Administration

Moderator: Leanne Miles, VT

Dover A-C

12:00 – 1:00 pm

Lunch

Grand Ballroom VI

1:00 – 1:50 pm

The New Medicaid Manged Care Rule: Practical Guidance from Multiple Viewpoints

Panelists: James Golden, CMS, Division of Managed Care Plans;

Michael McCoy, New Jersey State Comptroller Office;

Alexander Shekhdar, Medicaid Health Plans of America

Moderator: Penny Thompson, Penny Thompson Consulting

Harborside A-C

1:50 – 2:00 pm

Break

2:00 – 3:00 pm

Analytics in a Managed Care Setting

Speakers: Drew Gattine, Optum; Jeremy Hill, Optum

 Grand Ballroom I-IV

2:00 – 3:00 pm

Overcome the False Positive Blues. Actionable Strategies to Drive ROI

Speakers: Bradley K. Hart, Illinois Department of Healthcare & Family Services;

Brien Lorenze, Deloitte Transactions and Business Analytics LLP;

Dan Olson, CFE, Deloitte Transactions and Business Analytics LLP

 Grand Ballroom VII-X

2:00 – 3:00 pm

Unifying Teams with Investigative Case Management

Speaker: Richard Graham, BAE Systems

 Dover A-C

3:15 – 3:30 pm

Networking Break

Grand Ballroom V & Foyer 

3:30 – 4:30 pm

Making Sense Out of Disruption: Program Integrity in an Era of Payment Reform

Speakers: Jason Ganns, KPMG LLP; Ryan McCrosson, Esq., KPMG LLP;

Denise Poley, KPMG LLP

Grand Ballroom I-IV

3:30 – 4:30 pm

Front-End Program Integrity – A New Paradigm

Speakers: Rohit Agarwal, Digital Harbor;

Karen Johnson, CPA, California Dept. of Health Care Services (DHCS)

Grand Ballroom VII-X

3:30 – 4:30 pm

Inside the Mind of the White Collar Criminal

Panelists: William Avery, Pondera Solutions; Chuck Gallagher;

Mark Leon, Pondera Solutions;

Bruce Lim, CPA, California Department of Health Care Services;

Sharon E. Ormsby, CFE, Arizona Health Care Cost Containment System

Moderator: Amanda Huston, Pondera Solutions

Dover A-C

6:30 – 9:00 pm

NAMPI Reception

Sponsored by HMS

 Shuttles will depart from the main entrance of the Baltimore Marriott starting at 6:00 pm. 

The last shuttle will depart at 6:30 pm.

CONFERENCE AGENDA

Tuesday, August 30, 2016

8:00 am – 4:30 pm

Registration & Information

Grand Ballroom Foyer

7:30 – 8:30 am

Breakfast

Grand Ballroom VI

8:00 am – 4:30 pm

Exhibit Hall

Grand Ballroom V & Foyer

8:30 – 8:45 am

Business Meeting, Election of Officers
John F. McCormick, Connecticut Department of Social Services, NAMPI President

Harborside A-C

8:45 – 9:45 am

Medicaid Fraud: The Health Plan Perspective

Panelists: Ralph Carpenter, Aetna;

Katherine Leff, RN, CLU, ALHC, CPC, CHC, AHFI, CPE, CareSource;

Nicholas Messuri, DentaQuest;

 Rick Munson, AHFI, UnitedHealthcare

Moderator: John F. McCormick, CPA, Connecticut Department of Social Services, NAMPI President

Harborside A-C

9:45 – 10:45 am

PCA Fraud:  Prevention Detection and Prosecution

Speakers: Douglas Jones, Alaska Dept. of Health & Social Services;

Lynne Keilman-Cruz, Alaska Dept. of Health & Social Services

Moderator: MaryKay Cary, New Jersey Office of the State Comptroller, Chair, Regional Representatives

Grand Ballroom I-IV

9:45 – 10:45 am

PI Unit Organization and Placement

Speakers: Kelly Bennett, Florida Agency for Health Care Administration;

Andrew Linn, Florida Agency for Health Care Administration;

D. Kenneth Yon, Florida Agency for Health Care Administration

Moderator: Demetrese Evans, MS

Grand Ballroom VII-X

9:45 – 10:45 am

Preparing For the New PERM Eligibility Review and Other Proposed PERM & MEQC Changes

Speakers: Cindy Howe, Payment Accuracy & Reporting Group, CMS;

Bridgett Rider, Payment Accuracy & Reporting Group, CMS;

Tasha Trusty, Payment Accuracy & Reporting Group, CMS

Moderator: Anne Harvey, NE

Dover A-C

10:45 – 11:15 am

Networking Break

 Grand Ballroom V & Foyer

11:15 am – 12:15 pm

Beyond Fraud: Recover More and Improve Program Integrity with Broader Payment Integrity Initiatives and Data

Speakers: Gary Call, MD, HMS;

Michael Hostetler, HMS

 Grand Ballroom I-IV

11:15 am – 12:15 pm

The National Accuracy Clearinghouse: Fighting Fraud Across State Lines

Speaker: Richard K. Grape Jr., MPA,  MCMP – II, LexisNexis Risk Solutions

Grand Ballroom VII-X

11:15 am – 12:15 pm

Secret Ingredients for Implementing Payment Integrity Oversight in a Managed Care Environment

Speakers: Dennis J. Garvey, JD, Truven Health Analytics;

David Nelson, Truven Health Analytics

Dover A-C

12:15 – 1:15 pm

Lunch / Exhibit Booth Giveaways

 Grand Ballroom VI

1:15 – 2:00 pm

Texas’ New IG Integrity Initiative

Panelists: Stuart Bowen, Texas Health & Human Services Commission;

Sylvia Kauffman, Texas Health & Human Services Commission

Moderator: Lori Stiles, Idaho Dept. of Health & Welfare, NAMPI Treasurer

Harborside A-C

2:00 – 2:10 pm

Break

2:10 – 3:10 pm

Challenges Presented by New Drugs

Speaker: Michael Cohen, DHSc, JD, PA-C, US Dept. of HHS, Office of Inspector General

Moderator: Max Garner, TN

Grand Ballroom I-IV

2:10 – 3:10 pm

Long Term Care – Asset Discovery Investigations

Speaker: Bradley K. Hart, Illinois Department of Healthcare & Family Services

Moderator: Sharon E. Ormsby, CFE, AZ

Grand Ballroom VII-X

2:10 – 3:10 pm

Beneficiary Fraud by Recipients

Panelists: William Gilbert, NY State Office of Medicaid Inspector General;

Michael McKenzie, Wisconsin Department of Health Services

Moderator: Donna Kellow, CO

Dover A-C

3:10 – 3:30 pm

Networking Break

 Grand Ballroom V & Foyer

3:30 – 4:30 pm

Medicaid Member IDs are the New Credit Card Numbers: Understanding the Growing Threat of Medical Identity Theft Fraud in Medicaid

Speakers: Brady Augustine, Aggressive Analytics;

Steve Carlson, MedicFP;

Ruben J. King-Shaw Jr., Former COO & Deputy Administrator, CMS

Grand Ballroom I-IV

3:30 – 4:30 pm

PLATO® – Predictive Modeling Solution Use in Delaware

Speakers: Holly Pu, Health Integrity;

Pednika White, Deleware Division of Medicaid & Medical Assistance

Grand Ballroom VII-X

3:30 – 4:30 pm

Bending the HCBS Spending Curve: How to Quantify Provider Behavioral Change

Speakers: Thomas Aldridge, Public Consulting Group (PCG);

Kevin Hutchinson, MPP, Public Consulting Group (PCG)

Dover A-C

5:30 – 7:00 pm

Networking Event at Barcocina

Sponsored by Deloitte

1629 Thames St.

Shuttles will be provided to and from Barcocina starting at 5:20 pm. 

Please meet the shuttle in the main lobby of the Baltimore Marriott. 

CONFERENCE AGENDA

Wednesday, August 31, 2016

7:30 am – 12:15 pm

Registration & Information

Grand Ballroom Foyer

7:30 – 8:15 am

Breakfast

 Grand Ballroom VI

8:15 – 8:20 am

Daily Remarks

John F. McCormick, CPA, Connecticut Department of Social Services, NAMPI President

Harborside A-C

8:20 – 8:50 am

MII Update

Speakers: Clint Eisenhower, CMS, Center for Program Integrity;

Tom Falkinburg, Medicaid Integrity Institute (MII)

Moderator: Jacqueline Thomas, Alabama Medicaid Agency, NAMPI Vice President/President Elect

Harborside A-C

8:50 – 9:50 am

Visualizing Operational Performance Through Dashboards

Speakers: Sylvia Kauffman, Texas Health & Human Services Commission;

Alan Scantlen, Texas Health & Human Services Commission

Moderator: Bernadette Parks, MS

 Grand Ballroom I-IV

8:50 – 9:50 am

Combatting Fraud, Waste and Abuse in Behavioral Health Billing Practices

Speakers: Richard E. Kellogg, The Stephen Group;

Elizabeth Thomas Smith, Arkansas Office of the Medicaid Inspector General;

Moderator: Mindy Chavenelle, NH

Grand Ballroom VII-X

8:50 – 9:50 am

Dental Practice Overview

 Speaker: Bob Dwyer, DDS, WI

Moderator: Bekah Kutt, VT

Dover A-C

9:50 – 10:00 am

Break

10:00 – 11:00 am

CMS Investigations & Audits Group Update

Speakers: Peter Leonis, CMS, Investigations & Audits Group, Center for Program Integrity;

Mark Majestic, CMS, Investigations & Audits Group, Center for Program Integrity

Moderator: Joan Senatore, JD, MBA, CFE, CCH, Massachusetts Executive Office of HHS, NAMPI Past President

Harborside A-C

11:00 am – 12:00 pm

Panel Discussions: The Impact of NAMPI

John F. McCormick, CPA, Connecticut Dept. of Social Services, NAMPI President

Jacqueline Thomas, Alabama Medicaid Agency, NAMPI Vice President/President Elect

Lori Stiles, Idaho Dept. of Health & Welfare, NAMPI Treasurer

Otis Washington, Jr., Mississippi Division of Medicaid, NAMPI Secretary

Joan Senatore, JD, MBA, CFE, CCH, Massachusetts Executive Office of HHS, NAMPI Past President

 MaryKay Cary, New Jersey Office of the State Comptroller, Chair, Regional Representatives

Harborside A-C

12:00 – 12:15 pm

Closing Session

Laptop Giveaways

2017 Conference Registration Giveaway

 Announcement from 2017 Host State

Harborside A-C

12:00 pm

Boxed Lunch

 Foyer, Harborside A-C