Waste and abuse in behavioral health: Trends to watch in Medicaid and other lines of business

Register for the webinar Tuesday, May 19 at 1 pm ET

Staying informed on behavioral health fraud, waste, and abuse (FWA) is critical for today’s health plans, especially as Medicaid programs face increasing scrutiny, evolving regulations, and more sophisticated schemes. As treatment models expand and coding and documentation requirements continue to change, bad actors are finding new ways to exploit behavioral health services. While Medicaid has been hit hardest, many of the same schemes pose growing risks across other lines of business.

Join Cotiviti’s behavioral health and FWA experts for a timely, practical discussion on how these trends are unfolding—and what health plans can do to stay ahead.

During this webinar, you’ll learn:

The latest guidance designed to stop Medicaid fraud and abuse
How emerging behavioral health trends are being exploited by bad actors
Key takeaways from the recent federal release of behavioral health provider data
Tools and approaches to identify and stop FWA without creating provider abrasion

This session will equip SIUs and payment integrity teams with real‑world insights, data trends, and practical strategies they can apply immediately.

The National Health Care Anti-Fraud Association (NHCAA) is extending one (1) Continuing Professional Education credit towards the AHFI^® designation to attendees of the live webinar that complete the NHCAA attestation online.

Presenters:

Erin Rutzler, AHFI, CFE, CHC, CPC
Senior Vice President, Payment Integrity Operations
Cotiviti

Erin provides strategic direction and oversight of Cotiviti’s FWA, Coding Validation, and dental solutions. Serving as the company’s primary subject matter expert in investigations and FWA for compliance, client training, sales, and marketing activities, she regularly represents the company at industry conferences such as the National Health Care Anti-Fraud Association’s (NHCAA) Annual Training Conference (ATC).

Nikki Brody, AHFI
SIU Supervisor
Cotiviti

Nikki leads a team of senior investigators who analyze complex claims data, identify emerging FWA schemes, and conduct targeted prepayment investigations to protect plan assets and support program integrity. She has over 20 years of experience in the insurance industry, with 15 years combating healthcare FWA.

Kristen Hannah, CPC
Medical Review Supervisor
Cotiviti

Kristen has three decades of experience in healthcare, with extensive experience in behavioral health coding, billing, medical reviews, and compliance auditing. At Cotiviti, she continually stays abreast of Medicaid, Medicare, and commercial payer policies and guidelines and helps develop behavioral health policies and guidelines for content libraries. She oversees Cotiviti’s FWA postpayment medical review team and documentation audits, performing postpayment medical reviews and educating providers for a variety of payers.

Andrew Winebrenner
Senior Investigator
Cotiviti

Bringing more than seven years of experience in healthcare FWA to his role, Andrew is responsible for analyzing claims data to identify potential instances of FWA among medical providers and conducts postpay FWA investigations on behalf of health plans. Before joining Cotiviti, Andrew was an investigator for a national health insurance plan where he specialized in Medicare FWA investigations.