Speakers - Medicare

Speakers

Speaker Biographies

Zabeen Chong (CMS)

Zabeen Chong serves as the Director for the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Zabeen is responsible for leading initiatives to streamline provider screening and enrollment for over two million providers and implementing policies and systems to prevent fraud and abuse in the Medicare and Medicaid programs. This includes the development of Medicare and Medicaid provider enrollment operating policy and procedures, enumeration of provider applicants, oversight of the Provider Enrollment Chain & Ownership System, and providing outreach and education to the provider community. She is also responsible for the identification of vulnerabilities and implementation of administrative action processes directed at protecting Medicare and Medicaid provider enrollment. Prior to her current position, she served as the Director of the Website Project Management Group in the Office of Communications at CMS where she led the redesign and implementation of new technologies on www.medicare.gov and www.cms.gov as well as other web-based initiatives critical to advancing CMS' mission and operations. Zabeen has a Master's degree in Information Technology from the Johns Hopkins University and has worked at CMS for over 15 years.

Charles Schalm (CMS)

Charles Schalm has been serving as the Deputy Director for the Provider Enrollment & Oversight Group at the Center for Program Integrity at CMS since 2013. He is responsible for overseeing the federal screening, enrollment, and enforcement actions for 2.7 million providers and suppliers that serve over 65 million Medicare beneficiaries. Prior to joining CMS, Charles served in the private sector as a Program Integrity Director for Medicare and Medicaid fraud, waste, and abuse. He also worked with Medicaid managed care organizations in Pennsylvania and Michigan. He served on the national Medicare/Medicaid Healthcare Drug Taskforce where federal agencies and private organizations came together to tackle the onset of the opioid epidemic. Charles went to school at the University of Michigan and Duquesne University, where he graduated with degrees in business and forensics.

Adam Rubin, Esq. (CMS)

Adam Rubin serves as a senior technical advisor in the Provider Enrollment & Oversight Group in the Center for Program Integrity at CMS. He is responsible for assisting in the development of new program integrity regulations and statutes to further bolster CMS's mission of curbing fraud, waste, and abuse in the Medicare and Medicaid programs. Prior to joining CMS in 2016, Adam practiced as an Estates and Trusts attorney in Towson, MD. As a certified mediator, he has mediated workplace disputes under the umbrella of the Federal Shared Neutrals program. Adam received his J.D. from the University of Maryland Francis King Carey School of Law.

Joseph Schultz (CMS)

Joseph Schultz serves as a Deputy Director of the Division of Enrollment Policy and Operations within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Mr. Schultz is responsible for developing enrollment policies and working with the Medicare Administrative Contractors (MACs) and other stakeholders on provider enrollment and program integrity related issues. He has over 13 years' experience in Medicare for both the public and private sector. Joseph has a Master's degree in Healthcare Administration from Utica College in NY and undergraduate degree from the State University of New York at Cortland.

Anthony Peterson (Noridian)

Anthony Peterson is a manager in Provider Enrollment for Noridian Healthcare Solutions. Anthony is accountable for leading the Provider Enrollment team in Jurisdictions E and F, with a focus on equipping the team to empower providers and organizations with information related to all Medicare enrollment related activities. Anthony has over 15 years of experience in Medicare Provider Enrollment and over 12 years of experience leading people.

Stephanie Portzline (Novitas/FCSO)

Stephanie Portzline is the Manager of Provider Engagement for Novitas Solutions, Inc., and First Coast Service Options, the Part A and B Medicare Administrative Contractors (MAC) for Jurisdictions L, H, and N. She has served in various capacities in the Medicare program for more than 10 years, managing provider enrollment and contact center operations, critical and congressional provider and beneficiary inquiries, and the provider outreach and education program.

Shawn Cook (WPS)

Shawn Cook is the Manager of Provider Engagement for Wisconsin Physicians Service (WPS), the Part A and B Medicare Administrative Contractors (MAC) for Jurisdictions 5 and 8. She has served in various capacities in the Medicare program for more than 20 years, overseeing the provider enrollment and appeals operations and an integral part of the quality improvement and management program.

Delora Parks (CGI)

Delora Parks has spent the past 17 years supporting CMS programs and has served as the Operations Manager for the External User Services (EUS) Help Desk since 2015. As the Operations Manager, she has helped to streamline help desk processes to reduce unnecessary wait times and has spearheaded several technology upgrades to improve overall quality. Delora holds a Bachelor of Science in Decision Sciences and Management Information Systems, and a Master of Science in Data Analytics Engineering, both from George Mason University.

Alisha Sanders (CMS)

Alisha Sanders serves as the Director for the Division of Enrollment Policy & Operations within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Ms. Sanders is responsible for developing enrollment policies and procedures across the Medicare program and working with the Medicare Administrative Contractors (MACs) and other stakeholders on provider enrollment and program integrity related issues. Ms. Sanders has worked for CMS for over 25 years.

Marian Love (FCSO/Novitas)

Marian Love serves as the Sr. Director for the Provider Enrollment Center at First Coast Service Options. Ms. Love is responsible for the oversight of all Provider Enrollment functions for Medicare Administrative Contractor (MAC) Jurisdictions JN, JH, and JL and support of the NPEAST. She has been with First Coast for over 24 years and has a strong focus on a consistent and compliant experience for providers and suppliers that protects the Agency and Medicare beneficiaries. She has extensive knowledge of Provider Enrollment and its evolution as she has served in almost every role in Provider Enrollment. Marian has a Master's degree in Business Administration from California Coast University.

Melanie Bovard (CMS)

Melanie Bovard serves as a Health Insurance Specialist in the Division of Enrollment Policy and Operations within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Ms. Bovard works with the Medicare Administrative Contractors (MACs) and other stakeholders on provider enrollment and program integrity related issues. She is also part of the Survey and Certification Team, focusing on Skilled Nursing Facilities.

Dionna Johnson (CMS)

Dionna Johnson serves as a Business Function Lead and Survey and Certification Lead for the Division of Enrollment Policy & Operations within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Mrs. Johnson provides oversight over one the Medicare Administrative Contractors, Palmetto GBA, on provider enrollment and provider integrity related issues. Mrs. Johnson graduated with a Master's in Health Administration from George Mason University.

Erin Volk (Noridian)

Erin Volk is a Manager of Provider Enrollment for Noridian, the Part A and B Medicare Administrative Contractors (MAC) for Jurisdictions E and F. She has served in Provider Enrollment in the Medicare program for more than 10 years and the State Medicaid space for 3 years. Erin currently oversees the Part A team at Noridian, who has partnered with CMS to continue enhancing the Survey and Certification process.

William Price (NGS)

William Price serves as a Provider Enrollment Process Expert for National Government Services. Mr. Price is responsible for operationalizing change requests and technical direction letters issued by CMS, analyzing complex enrollment escalations and CMS and A/B MAC collaboration efforts. William recently completed the Anthem Future Leaders program and the Anthem FGS Leadership and Growth development program. With over a decade of Medicare and Medicaid experience, Mr. Price offers significant enrollment expertise and insight.

Dennis Grindle (Eide Bailly)

CPA and Partner with Eide Bailly LLP National Specialty Services Group

Dennis Grindle has been working with healthcare clients across the county for over 38 years on Medicare provider enrollment and compliance issues, Medicare provider enrollment appeals, Medicare provider-based regulations, Medicare reimbursement issues, physician and non-physician practitioner Medicare billing rules, licensure, and other related issues. Dennis is a frequent presenter on all these topics at a local, state, and national level. He also serves on the CMS Central Office PECOS Focus Group and the CMS Central Office Provider Compliance Focus Group.

Dennis graduated in 1983 with a Bachelor of Science degree in Business Administration with a specialization in Accounting from the University of Nebraska at Omaha and is a member of the American Institute of Certified Public Accountants, Nebraska Society of Certified Public Accountants, American Health Lawyers Association and Healthcare Financial Management Association.

Gretchin Heckenlively (Eide Bailly)

CPA, FHFMA and Partner with Eide Bailly LLP National Specialty Services Group

Gretchin Heckenlively has over 27 years of experience in healthcare, both in public accounting (23 years) and as the Chief Financial Officer of a hospital (4 years). Gretchin primarily focuses on Medicare and Medicaid provider enrollment, Medicare provider-based issues, licensure, and reimbursement, serving clients of all sizes and markets across the United States. She has given many presentations on a wide range of healthcare topics and serves as one of the primary speakers at the National Medicare Provider Enrollment Compliance Conference held annually. She currently serves on the CMS Central Office PECOS Focus Group and is currently serving a two-year board appointment as the Public Member of the National Association of Medical Staff Services.

Gretchin graduated in 1997 with a Bachelor of Science degree in Accounting and Finance and is a member of the American Institute of Certified Public Accountants, Nebraska Society of Certified Public Accountants and American Health Lawyers Association. Additionally, she is an active member of the Healthcare Financial Management Association, previously serving as the President of the Nebraska Chapter and Treasurer of HFMA Region 8.

Daniel Johnson (Palmetto GBA)

Daniel Johnson is a Provider Enrollment Supervisor for Palmetto GBA. Daniel has over 24 years of government healthcare program experience and joined Palmetto GBA six years ago as an enrollment analyst. Currently he is responsible for Provider Enrollment's Internal Quality Control team and oversees training activities specific to Provider Enrollment. In these roles, Daniel monitors the quality of work completed by Provider Enrollment staff and develops training material for Provider Enrollment as well as other areas such as the Provider Contact Center.

Sarah Darnley (CMS)

Sarah Darnley serves as the DME Policy Team Lead for the Division of Enrollment Policy & Operations within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. Ms. Darnley is responsible for developing DMEPOS enrollment policies and procedures with the National Provider Enrollment DMEPOS contractors (NPEs) and other stakeholders on provider enrollment and program integrity related issues. Ms. Darnley has 9 years of experience in Medicare provider enrollment in both the public and private sector. Sarah has a B.A. in Health Administration and Policy from the University of Maryland Baltimore County and an M.S. in Health Care Administration from Oklahoma State University.

Cambra Lee-Shapiro (CMS)

Cambra Lee-Shapiro serves as a Health Insurance Specialist in the Division of Enrollment Policy & Operations within the Provider Enrollment & Oversight Group in the Center for Program Integrity at CMS. She is responsible for providing DMEPOS policy support and working with the Medicare Administrative Contractors (MACs) and other stakeholders on provider enrollment and program integrity related issues. Cambra is also part of the Survey & Certification Team, focusing on Hospitals, End-Stage Renal Disease Facilities, and Outpatient Rehabilitation Providers. She has 6 years of experience working in public health and health care in both the public and private sector. Cambra has a Bachelor's degree from Cornell University and a Master's degree in Public Health from Harvard University.

Barry McManus (NPE West DME)

Barry has worked on the National Supplier Clearinghouse (NSC) and National Provider Enrollment (NPE) contracts since 1997. After spending two years as an Enrollment Analyst processing applications and taking customer service calls, he moved into the Supplier Audit and Compliance Unit working to protect the Medicare Trust Fund by ensuring DMEPOS suppliers were compliant with Medicare rules and regulations. In 2008 he was part of a group that won the Office of Inspector General Cooperative Achievement Award for work in South Florida. In 2019, Barry moved into the Project Manager role over the NSC and oversaw the transition to the current NPE contracts where he remains Project Manager for the NPE West.

Steve Simmerman (The Compliance Team)

For the past seventeen years, Steve Simmerman has served on the Executive Team of The Compliance Team, Inc. (TCT) with over 30 plus years of experience in multiple areas of the healthcare industry. As the Chief Operating Officer, he oversees all operations of the accreditation programs within TCT's portfolio, including those programs under deeming authority by The Centers of Medicare and Medicaid Services (CMS). Prior to joining TCT, Simmerman holds experience in emergency vehicle compliance and manufacturing, durable medical equipment, pharmacy, and paramedic services. Residing local to the Spring House, PA office, Steve is active in spending time with his family.

Vani Annadata (CMS)

Vani Annadata serves as the Director of the Division of Enrollment Systems within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. She is responsible for overseeing the National Medicare Provider Enrollment System (PECOS), the National Plan & Provider Enumeration System (NPPES) and the provider enrollment screening system. Vani has been with CMS for over twelve years. She has an extensive background in software and systems development for over 15 years in private sector and holds a degree in Engineering.

Gina Aughenbaugh (CMS)

Gina Aughenbaugh, MSW, serves as a business function lead with the Provider Enrollment and Oversight Group in the Center for Program Integrity at the Centers for Medicare & Medicaid Services (CMS). She is responsible for providing operations and policy guidance related to Medicare provider enrollment. She works with multiple Medicare Administrative Contractors including First Coast Service Options Inc. and Novitas Solutions Inc. She also works with the Site Verification Services Contractors, Deloitte SVS West PMO and Palmetto GBA. Prior to joining CMS in 2019, she was a social worker and has over 10 years of experience in the medical field. Mrs. Aughenbaugh holds a Bachelor of Arts with a focus in community and mental health and a minor in counseling and a Master of Social Work, both from the University at Buffalo.

Allison Bloom (CMS)

Allison Bloom serves as the Deputy Director of the Division of Enforcement Actions within the Provider Enrollment and Oversight Group in the Center for Program Integrity at CMS. She is responsible for overseeing and developing policy surrounding the implementation of administrative actions, including enrollment denials, revocations, and deactivations of provider's Medicare billing privileges. Allison has a BS from The Pennsylvania State University and has been with CMS for 8 years.