As fraud schemes become increasingly complex, healthcare organizations must stay ahead of evolving threats that impact both clinical and financial integrity. This session will explore the latest fraud trends across the healthcare landscape - from billing manipulation and phantom providers to evolving schemes in hospice, home health, telehealth, and behavioral health. Join industry leaders as they share real-world examples, warning signs to watch for, and proactive strategies for detecting, preventing, and responding to fraud across care settings.
Michael Devine
Peter Monson
Mandi Heiple
Mandi Heiple is the Director of Payment Integrity at Medica, where she leads a high-performing team dedicated to ensuring accurate, compliant, and efficient claims payment across commercial and government lines of business. She oversees end-to-end payment integrity strategy – from prospective editing and coding validation to retrospective audits. Her teams drive measurable savings while protecting provider relationships and improving member experiences.
With over 20 years in healthcare operations and payment integrity, Mandi has focused on designing and implementing solutions that close process gaps, reduce improper payments, and strengthen compliance frameworks.
Karen Weintraub
With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college.