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Presentations

35th Annual NAMPI Conference Agenda

Sunday, August 25, 2019

4:15 PM – 5:15 PM SESSIONS

Monday, August 26, 2019

9:30 AM – 10:30 AM OIG HEALTHCARE FRAUD TRENDS

OIG HEALTHCARE FRAUD TRENDS  

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

Moderator: Lori Stiles, Idaho, NAMPI President

11:00 AM – 12:00 PM MORNING SESSIONS [CLICK FOR DETAILS]

 

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

 

2:10 PM– 3:10 PM AFTERNOON SESSIONS [CLICK FOR DETAILS]

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

 

3:30 PM– 4:30 PM AFTERNOON SESSIONS [CLICK FOR DETAILS]

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

 

Tuesday, August 27, 2019

8:30 AM – 9:20 AM MEDICAID FRAUD CONTROL UNIT UPDATE

MEDICAID FRAUD CONTROL UNIT UPDATE

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

9:30 AM – 10:30 AM MORNING SESSIONS [CLICK FOR DETAILS]

CLUSTERING OF THERAPY SERVICES AT NURSING FACILITIES

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


INVESTIGATIVE REVIEW PROCESS

Speakers:
Maureen Barker, Florida Agency for Health Care Administration;
Jessica Zeedyk, Florida Agency for Health Care Administration


CMS MEDICAID PROVIDER SCREENING AND ENROLLMENT UPDATE

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

2:00 PM– 3:00 PM AFTERNOON SESSIONS [CLICK FOR DETAILS]

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 COMBATING 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


Data to Detect Solicitation

Panelists:
Sylvia Hernandez Kaufman; Inspector General, Texas Health & Human Services Commission
Olga Rodriguez; Chief of Strategy Officer, Texas Health & Human Services Commission, Office of Inspector General

3:10 PM – 4:10 PM AFTERNOON SESSIONS [CLICK FOR DETAILS]

Wednesday, August 28, 2019

8:00 AM – 8:45 AM CMS, CENTER FOR PROGRAM INTEGRITY UPDATES & COLLABORATIVE APPROACHES

CMS, CENTER FOR PROGRAM INTEGRITY UPDATES & COLLABORATIVE APPROACHES

Speaker:
Alec Alexander, CMS, Center for Program Integrity 

Moderator: Lori Stiles, Idaho, NAMPI President

8:45 AM – 9:45 AM CMS INVESTIGATIONS & AUDITS GROUP (IAG) UPDATES

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

10:00 AM – 11:00 AM MORNING SESSIONS [CLICK FOR DETAILS]

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

 

11:15 AM – 12:00 PM CMS UPDATE: THE NEW MEQC AND PERM PROGRAM REQUIREMENTS

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

 

12:00 PM – 1:00 PM PAYMENT SUSPENSIONS PANEL

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

 

1:00 PM – 1:15 PM CLOSING SESSION

CLOSING SESSION

Computer Giveaways
2020 Conference Registration Giveaway
Announcement from 2020 Host State

 

THE NAMPI MISSION

To safeguard the fiscal, operational and program integrity of Medicaid programs while enhancing communication between members and other agencies, utilizing most current technology and methodology in the dissemination of collective information to members and the federal government.

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