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Center for Program Integrity

Shantanu Agrawal, M.D., Deputy Administrator and Director

Vacant, Deputy Policy Director

Elisabeth Handley, Deputy Operations Director

State Liaison Staff

Elisabeth Handley - Acting Director

Business Services Group

Teresa Krause - Director

Provider Enrollment Operations Group

Zabeen Chong, Director
Division of Enrollment Systems - Richard Gilbert, Director
Division of Enforcement Actions - Charles Schalm, Acting Director
Division of Enrollment Operations - Zabeen Chong, Acting Director

Data Analytics and Systems Group

Raymond Wedgeworth, Director
Division of Systems Management - Erick Royle, Director
Division of Modeling and Analytics - Linda Smith, Director
Division of Outcomes Measurement - Marin Gemmill-Toyama, Acting Director

Data Sharing and Partnership Group

Douglas Brown, Director
Division of Stakeholder Engagement and Outreach - Toula Bellios, Director
Division of Data and Informatics - Madhu Annadata, Director

Investigations and Audits Group

Mark Majestic, Director
Division of Plan Oversight and Accountability - Camille Brown, Acting Director
Division of State Program Integrity - Letitia Leaks, Director
Division of Provider Investigations and Audits - Lori Bellan, Acting Director
North Division of Field Operations - Joel Truman, Acting Director
South Division of Field Operations - Fernando Alvarez, Acting Director
East Division of Field Operations - Peter Leonis, Director
West Division of Field Operations - Suzanne Bradley, Director

Contract Management Group

Vacant, Director
Division of Contract Management - Desiree Wheeler, Director
Division of Contractor Performance and Assessment - Olivia Williams, Director
Division of Acquisition Strategies and Planning - Kenneth Fleet, Director

Governance Management Group

Kelly Gent, Acting Director
Division of Vulnerability Governance - Crystal High, Director
Division of Policy and Regulations - John Spiegel, Director
Division of Performance and Oversight - Kelly Gent, Acting Director

Functional Statement

  • Serves as CMS' focal point for all national and State-wide Medicare and Medicaid programs and CHIP integrity fraud and abuse issues.
  • Promotes the integrity of the Medicare and Medicaid programs and CHIP through provider/contractor audits and policy reviews, identification and monitoring of program vulnerabilities, and providing support and assistance to States. Recommends modifications to programs and operations as necessary and works with CMS Centers, Offices, and the Chief Operating Officer (COO) to affect changes as appropriate. Collaborates with the Office of Legislation on the development and advancement of new legislative initiatives and improvements to deter, reduce, and eliminate fraud, waste and abuse.
  • Oversees all CMS interactions and collaboration with key stakeholders relating to program integrity (i.e., U.S. Department of Justice, DHHS Office of Inspector General, State law enforcement agencies, other Federal entities, CMS components) for the purposes of detecting, deterring, monitoring and combating fraud and abuse, as well as taking action against those that commit or participate in fraudulent or other unlawful activities.
  • In collaboration with other CMS Centers, Offices, and the COO, develops and implements a comprehensive strategic plan, objectives and measures to carry out CMS' Medicare, Medicaid and CHIP program integrity mission and goals, and ensure program vulnerabilities are identified and resolved.