CA Medicaid Program Integrity | Kisaco Research

CA Medicaid Program Integrity

This session will focus on:

  • California’s efforts to combat fraud, waste and abuse in Medi-Cal, California’s Medicaid program.

  • How California is exploiting available data and data sharing opportunities for purposes of Medicaid program integrity objectives.

  • A summary of program integrity best practices from the perspective of a Medicaid Program Integrity Director.

  • California’s future vision with regards to the use of data and data analytics to support its Medi-Cal fraud-control strategy.

Learning Objectives:

  • Obtain program integrity best practices that can be leveraged by the participating entity.

  • Discover new ways to exploit data to identify and develop actionable leads.

  • Performance metrics and return on investment – ways to measure success.

Session Topics: 
Payment Integrity
Speaker(s): 

Author:

Bruce Lim

Deputy Director, Audits and Investigations
California Department of Health Care Services (DHCS)

Bruce Lim serves as the Deputy Director, Audits and Investigations, for the California Department of Health Care Services (DHCS) and is the designated Program Integrity Director for Medi-Cal, California’s Medicaid program. Mr. Lim is a certified public accountant (CPA) with over 32 years of audit and financial management experience in both the private and public sectors. Past employers include Kenneth Leventhal and Company, CPAs (Ernst & Young Kenneth Leventhal Real Estate Group), Packard Bell NEC, and the California Department of Food and Agriculture.

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Bruce Lim

Deputy Director, Audits and Investigations
California Department of Health Care Services (DHCS)

Bruce Lim serves as the Deputy Director, Audits and Investigations, for the California Department of Health Care Services (DHCS) and is the designated Program Integrity Director for Medi-Cal, California’s Medicaid program. Mr. Lim is a certified public accountant (CPA) with over 32 years of audit and financial management experience in both the private and public sectors. Past employers include Kenneth Leventhal and Company, CPAs (Ernst & Young Kenneth Leventhal Real Estate Group), Packard Bell NEC, and the California Department of Food and Agriculture.