RISE National is proud to welcome the Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) back to the 2024 agenda for keynote addresses, as well as a panel of OIG experts for a deep dive session on 2024 priorities. Join us for essential regulatory updates and get your most pressing questions answered related to the recently released 2025 Advance Notice.
By popular demand, we welcome Christi A. Grimm back to RISE National for the second year in a row to provide an informative keynote address answering your most pressing questions about the changes from the CMS Final Rule and the evolving Medicare Advantage landscape.
Christopher G. Bresette is the Director of Medicare Part C Audits with the United States Department of Health and Human Services (HHS), Office of Inspector General, Office of Audit Services. Mr. Bresette is responsible for the implementation and coordination of all audits of the Medicare Advantage program. Based on more than 30 years of experience, he provides expert advice to other auditors about the design and execution of those audits. In addition, Mr. Bresette has a wealth of knowledge regarding other HHS programs, including traditional Medicare and Medicaid, and has conducted several audits designed to detect and prevent fraud, waste, and abuse. Mr. Bresette also provides training to new and experienced auditors about the Medicare Advantage program. Mr. Bresette graduated with honors from Rockhurst University with a BSBA in Accounting and is a certified public accountant, licensed in Missouri. Mr. Bresette has received numerous exceptional achievement awards and was previously bestowed with one of the agency’s highest honors when he received the Inspector General’s Bronze Award for the outstanding auditor of the year.
Alexis Mills is a Social Science Research Analyst in the New York regional office of the Office of Evaluation and Inspections within the U.S. Department of Health and Human Service’s Office of Inspector General. Alexis’ research areas of expertise include Medicare Fee-for-Service, Medicare Advantage, telehealth, remote patient monitoring, and T-MSIS. Alexis received a Master of Science in Social Work from Columbia University.
Miriam is a Subject Matter Expert in the Office of Evaluation and Inspections within the U.S. Department of Health and Human Service’s Office of Inspector General. Miriam has led dozens of evaluations on a variety of HHS programs. Her areas of expertise include telehealth, opioid prescribing, and Medicare Part D. Miriam received a Master of Science from the London School of Economics and Political Science in Public Policy and Administration.
Brian Martens is the Director of Strategic Projects and Initiatives at the Department of Health and Human Services, Office of Inspector General, Office of Investigations in Washington, DC. Brian provides technical guidance, advice, and expertise in Medicare Advantage and with various fraud schemes across the Medicare program. He has over 20 years investigating and managing successful outcomes in over 350 criminal and civil cases resulting in over $1 billion in restitution and settlements. He collaborated in the development of data analytics with the DOJ Strike Force initiative, testified before the Senate Special Committee on Aging, initiated healthcare fraud working groups, and managed multiple high-profile Medicare Advantage investigations. Brian received his Bachelor of Arts from Florida International University and is a Veteran of Foreign Wars.
Carolyn Kapustij serves as a Senior Advisor for Managed Care at the Office of Inspector General (OIG) for the Department of Health and Human Services. At OIG, she develops and leads enterprise-wide strategies to oversee Medicare Advantage and Medicaid Managed Care programs. She previously worked at the Centers for Medicare and Medicaid Services (CMS) and oversaw the improper payment measures for Medicare Part C and Part D, developed program integrity activities for the Federally Facilitated Exchanges, and developed payment policy for MA and Medicare Part D plans. She holds a Master of Public Health from the University of Michigan.
Allison Wiley is the Director of the Division of Policy and Analysis for the Payment Policy and Financial Management Group in the Center for the Consumer and Insurance Oversight (CCIIO) in the Centers for Medicare and Medicaid Services (CMS). Her team is responsible for the policies associated with the financial management programs established in the Affordable Care Act, as well as parts of the No Surprises Act. Her team’s work includes the policies governing the HHS-operated risk adjustment program and HHS-operated risk adjustment data validation. In her previous role, she served as the technical policy lead for HHS-operated risk adjustment program and HHS-operated risk adjustment data validation and has previously served as a subject matter expert on the essential health benefits and actuarial value.
Daphne Letherer is a subject matter expert in the Division of Risk Adjustment Operations for the Payment Policy and Financial Management Group in the Center for Consumer and Insurance Oversight (CCIIO) in the Centers for Medicare & Medicaid Services (CMS). Daphne’s work focuses on the operations of HHS-operated risk adjustment data validation in the Affordable Care Act markets, and her team leads the technical assistance and outreach efforts for participants of HHS-operated risk adjustment data validation.