Registration & Information 

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STATE REGIONAL ROUND TABLES

[CLOSED SESSION: STATE AND MEDICAID HEALTH PLAN ATTENDEES ONLY]
Moderator: Kelly Bennett, Florida Agency for Health Care Administration; Chair, Regional Representatives 

OPENING REMARKS & WELCOME BY NAMPI BOARD

Lori Stiles, Idaho Department of Health & Welfare; NAMPI President
Sharon Ormsby, Arizona Health Care Cost Containment System (AHCCCS); NAMPI Vice President
Brad Hart, Illinois Department of Healthcare & Family Services; NAMPI Treasurer
Joan Senatore, JD, CFE, CHC, Massachusetts Executive Office of Health and Human Services, NAMPI Secretary
Kelly Bennett, Florida Agency for Health Care Administration; Chair, Regional Representatives
Jacqueline Thomas, Alabama Medicaid Agency; NAMPI Past President

TOPIC SPECIFIC ROUND TABLES  

[OPEN SESSION: ALL ATTENDEES INVITED]
Topics Include:
  The use of statistical sampling/extrapolation in audits (both FFS and MC)
  Beneficiary fraud issues
  Pharmacy fraud, including issues with 340B billings
  Behavioral Health schemes & investigative best practices
  Data analysis efforts to distinguish fraud (referrals to MFCU) vs. abuse (for MPI to
investigate)
  Medicare-related issues (crossover recoupment, use of Medicare data to audit Medicaid)
  Healthcare Fraud Prevention Partnership in Medicaid
  Issues related to Managed Care Plan subcontractors (e.g., PBMs, transportation, etc.)
Moderator: Kelly Bennett, Florida Agency for Health Care Administration; Chair, Regional Representatives

BREAK

BORN TO AUDIT? DON’T FORGET YOUR MES!

Panelists: Ryan Farrell, Myers and Stauffer; Randy Rehn, Myers and Stauffer

ELECTRONIC VISIT VERIFICATION AND FWA: LEVERAGING TECHNOLOGY TO IMPROVE PROGRAM INTEGRITY

Speakers: Suzanne Crane, Optum; Robyn Ballard, Optum

FIRST DATA, AUTHENTICARE® ELECTRONIC VISIT VERIFICATION (EVV) SOLUTION

Speaker: Asad Salahuddin, First Data

CUTTING THROUGH THE HYPE OF AI: WHAT REALLY WORKS FOR PROGRAM INTEGRITY

Speakers: Kleber Gallardo, Alivia Analytics; Brendan Magauran, MD, Alivia Analytics, Boston Medical Center; Burton Meche, Louisiana Department of Health; Matthew Perryman, Alivia Analytics 

EXHIBIT HALL OPENING RECEPTION

sponsored by 2019 CONFERENCE EXHIBITORS

BREAKFAST

TBD

Exhibit Hall

OPENING REMARKS / WELCOME ADDRESS

Lori Stiles, Idaho Department of Health & Welfare; NAMPI President
Frank W. Berry, Commissioner, Georgia Department of Community Health (DCH)

KEYNOTE ADDRESS SPONSORED BY KPMG

Speaker: Curtis Zimmerman, Author, Life at Performance Level
Introduction by: Joseph Cassano, KPMG LLP

OIG HEALTHCARE FRAUD TRENDS  

Speaker: Korby Harshaw, Office of Inspector General, U.S. Department of Health & Human Services

Moderator: Lori Stiles, Idaho, NAMPI President

NETWORKING BREAK

FRAUD REFERRALS IN MANAGED CARE

Panelists: Lori Peters, WellCare Health Plans, Inc.; Floyd Price, Division of TennCare
Moderator: Kelly Bennett, Florida Agency for Health Care Administration

OIG UPDATE ON EXCLUSIONS

Speaker: Charles Grant, Office of Inspector General, U.S. Department of Health & Human Services
Moderator: Elizabeth Brooks, Georgia

MEDICARE CROSSOVER RECOUPMENT

Speaker: Robert G. Anderson, Mississippi Division of Medicaid
Moderator: Jacqueline Thomas, Alabama, NAMPI Past President

DATA IN HEALTH CARE INVESTIGATIONS

Panelists: Scott Caspall, Healthcare Fraud Prevention Partnership (HFPP) Trusted Third Party (TTP); Jacob Gray, Healthcare Fraud Prevention Partnership (HFPP) Trusted Third Party (TTP); Barret Wolters, Missouri Medicaid Audit and Compliance Unit
Moderator: Fritz Jenkins, Oregon

LUNCH

HOW TO ESTABLISH GOOD WORKING RELATIONSHIPS BETWEEN MFCUS & STATE PI UNITS

Panelists:
Randy Clouse, Medicaid Fraud Control Unit of Virginia, NAMFCU President 
Louis Elie, Department of Medical Assistance Services Virginia
Bruce Lieberman, Medicaid Fraud Control Unit of Alabama 
Ken Robins, Medicaid Fraud Control Unit of Idaho
Lori Stiles, Idaho Department of Health & Welfare, NAMPI President

Jacqueline Thomas, Alabama Medicaid Agency, NAMPI Past President

Moderator: Bakeba Thomas, Alabama Medicaid Agency

NETWORKING BREAK

INCORPORATING NON-TRADITIONAL DATA INTO YOUR WORKFLOW
WILL EXPAND YOUR DECISION MAKING PROCESSES

Speaker: Justin Hyde, LexisNexis Risk Solutions

CMS MEDICAID PROGRAM INTEGRITY STRATEGY: STATE IMPACTS AND EXPECTATIONS

Speakers:
Bradley Hart, Illinois Department of Healthcare and Family Services
Clint Eisenhower, Mathematica 
Jonathan Morse, Mathematica

MAXIMIZE YOUR PROGRAM INTEGRITY EFFECTIVENESS BY APPLYING TECHNOLOGY, EXPERTS AND PROGRAM DESIGN
TO DRIVE REAL-WORLD RESULTS

Panelists:
Kelly Bennett , Florida Agency for Health Care Administration 
John Oswald, HMS
Kendall Spence, HMS
Heidi Robbins Brown, JD, HMS

NETWORKING BREAK

WORK REQUIREMENTS AND COMMUNITY ENGAGEMENT

Speaker: John Crouse, MAXIMUS

HUMANS V. ROBOTS: HOW AI AND MACHINE LEARNING HELP MEDICAID INVESTIGATORS FIGHT FRAUD

Speakers:
Gene D’Angelo, Pondera Solutions; Jacob Gray, Healthcare Fraud Prevention Partnership Trusted Third Party; Keri Geiger, Microsoft; Amanda Huston, Pondera Solutions

MEDICAID/MEDICARE NEXUS

Speakers:
Tim Fickle, Qlarant
Santosh Ghumare, Qlarant
Aimee Mason, Qlarant
Ariel Reed, Qlarant

NAMPI RECEPTION SPONSORED BY HMS

Max Lager’s Wood-Fired Grill and Brewery

BREAKFAST

TBD

Exhibit Hall [TBD]

BUSINESS MEETING, ELECTION OF OFFICERS

Lori Stiles, Idaho Department of Health & Welfare; NAMPI President

TBD

MEDICAID FRAUD CONTROL UNIT UPDATE

Speaker: Randy Clouse, Medicaid Fraud Control Unit of Virginia; NAMFCU President
Moderator: TBD

TBD

BREAK

CLUSTERING OF THERAPY SERVICES AT NURSING FACILITIES

Speaker: Steve Sizemore, Texas Health and Human Services Commission, Office of Inspector General
Moderator: TBD

TBD

DEVELOPING BEST PRACTICES FOR MCO & GOVERNMENT COLLABORATION TO FIGHT MEDICAID FRAUD

Speakers:
Kelly Bennett, Florida Agency for Health Care Administration;
Gary Cantrell, HHS-OIG ;
Keesha Mitchell, Medicaid Fraud Control Unit of Ohio ;
Rick Munson, UnitedHealthcare
Moderator: TBD

TBD

USING RISK-BASED MODELS TO DRIVE PI EFFORTS

Speaker: Tim Helms, Florida Agency for Health Care Administration;
Moderator: TBD

TBD

CMS MEDICAID PROVIDER SCREENING AND ENROLLMENT UPDATE

Speakers:
Michael Cimmino, CMS, Division of Enrollment Operations;
Brenda Mullens, CMS, Division of Enrollment Operations
Moderator: TBD

TBD

NETWORKING BREAK

ACHIEVE YOUR PROGRAM MISSION: ACCELERATING PI THROUGH ORGANIZATIONAL CULTURE AND TECHNOLOGICAL CAPABILITIES

Speakers:
Megan Beckwith  KPMG, LLP;
Joseph Cassano, KPMG, LLP ;
Timothy Comello, KPMG, LLP

TBD

ACTIONABLE ANALYTICS: INCREASING RECOVERIES AND COST AVOIDANCE IN EMERGING FRAUD RISKS

Speakers: Fernando Alvarez, Deloitte; Al Santos, Deloitte
Moderator: Amina Popowich, Deloitte

TBD

TARGETING MEDICAID POLICY CHALLENGES IN PROGRAM INTEGRITY

Speakers:
Tim Cooper, IBM Watson Health;
Jillian Scalvini, AHFI , IBM Watson Health;
Maggie Trautman, Idaho Department of Health & Welfare

TBD

LUNCH & EXHIBIT BOOTH GIVEAWAYS

TBD

TAKING STOCK: A CONVERSATION WITH JULIE BOUGHN OF CMS

Speaker: Julie Boughn, CMS
Moderator: Penny Thompson, Penny Thompson Consulting

NETWORKING BREAK

EVV – EARLY LESSONS LEARNED

Speakers:
Kelly Bennett, Florida Agency for Health Care Administration;
Kristy Wathan, Ohio Department of Medicaid;
Anne Harvey, Nebraska Medicaid & Long-Term Care
Moderator: Bernadette Parks, Mississippi

WHICH IS A BETTER TOOL FOR COMBATTING BENEFICIARY FRAUD:
CIVIL RECOUPMENT OR CRIMINAL CONVICTION?

Speaker:
Kim Harmon, Tennessee Office of Inspector General;
Marcie Stephens, Tennessee Office of Inspector General
Moderator: Joan Senatore, Massachusetts, NAMPI Secretary 

CROSS-TRAINING BETWEEN MFCU AND PI UNITS

Panelists:
Elizabeth Smith, Arkansas Office of the Medicaid Inspector General; Donna Galloway, Arkansas Medicaid Fraud Control Unit; Lisa DeLaVergne, Washington State Health Care Authority; Larissa Payne, Washington Medicaid Fraud Control Unit
Moderator: Brad Hart, Illinois, NAMPI Treasurer

NETWORKING BREAK

HEALTHCARE IN THE POST-HONESTY ERA

Speaker: Carl Hammersburg, SAS

CHANGING THE BREAKING POINT – HOW TO PLAN FOR LTSS GROWTH BY OVERSIGHT

Speaker: Jay Peck, Public Consulting Group

DATA STRATEGIES TO COMBAT THE OPIOID EPIDEMIC

Speaker: Elliot Flautt, Tyler Technologies

NETWORKING EVENT SPONSORED BY DELOITTE

White Oak Kitchen & Cocktails

BREAKFAST

CMS, CENTER FOR PROGRAM INTEGRITY UPDATES & COLLABORATIVE APPROACHES

Speaker:
Alec Alexander, CMS, Center for Program Integrity 

Moderator: Lori Stiles, Idaho, NAMPI President

CMS INVESTIGATIONS & AUDITS GROUP (IAG) UPDATES

Panelists:
Laurie Battaglia, CMS, Investigations & Audits Group;
Elizabeth Lindner, CMS, Investigations & Audits Group ;
Kathleen McGinty, CMS, Investigations & Audits Group ;
Joy Sparks, JD , CMS, Investigations & Audits Group
Moderator: Sharon Ormsby, Arizona, NAMPI Vice President

IS IT FRAUD?

Panelists:
Mykel Fry, Medicaid Fraud Control Unit of Oklahoma;
Bruce Lieberman, Medicaid Fraud Control Unit of Alabama ;
Larissa Payne, Medicaid Fraud Control Unit of Washington;
Matt Whitmire, Medicaid Fraud Control Unit of Indiana
Moderator: Fred Becknell, Florida

USING RISK-BASED MODELS TO DRIVE PI EFFORTS

Speaker:
Tim Helms, Florida Agency for Health Care Administration;
Moderator: Kelly Bennett, Florida NAMPI Regional Representatives Chair

A FACETED APPROACH TO PROGRAM INTEGRITY

Speakers:
Anne Dvorak, Texas Health & Human Services Commission, Office of Inspector General;
Steve Johnson, Texas Health & Human Services Commission, Office of Inspector General
Moderator: Fritz Jenkins, Oregon

BREAK/HOTEL CHECK-OUT

CMS UPDATE ON THE IMPLEMENTATION OF THE NEW MEQC AND PERM PROGRAM REQUIREMENTS: IMPLICATIONS AND IMPACT ON STATE MEDICAID OPERATIONS

Speakers:
Joel Truman, CMS, CPI, Government Management Group
Moderator: Brad Hart, Illinois, NAMPI Treasurer

PAYMENT SUSPENSIONS PANEL

Panelists:
Mark Collins, Medicaid Fraud Control Unit of Nebraska ;
Renee Gallagher, Indiana Medicaid;
Anne Harvey, Nebraska Medicaid & Long-Term Care;
Matt Whitmire, Medicaid Fraud Control Unit of Indiana
Moderator: Lori Stiles, Idaho, NAMPI President

CLOSING SESSION

Computer Giveaways
2020 Conference Registration Giveaway
Announcement from 2020 Host State

Boxed Lunches Available

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