Center for Program Integrity

Peter Budetti, Deputy Administrator and Director

Ted Doolittle, Deputy Policy Director

Elisabeth Handley, Deputy Center Director

Business Operations Staff 

Teresa Krause - Director

Medicare Program Integrity Group

John Spiegel, Director
Division of Medicare Integrity Contractor Operations - Eileen Turner, Director
Division of Plan Oversight and Accountability - Tanette Downs, Director
Division of Policy and Regulatory Development - Vacant, Director

Medicaid Program Integrity Group

Angela Brice-Smith, Director
Division of Medicaid Integrity Contracting - Crystal High, Director
Division of Field Operations - Peter Leonis, Acting Director
Division of Audits and Accountability - Stephen Calfo, Director

Provider Enrollment Operations Group 

Zabeen Chong, Director
Division of Enrollment Systems - Mark Majestic, Acting Director
Division of Enrollment Policy - Zabeen Chong, Acting Director

Data Analytics and Control Group

Kelly Gent, Director
Systems Management Division - William C. Mooney, Director
Analytics Lab Division - Linda Smith, Acting Director
Command Center Division - Brenda Emanuel, Director
Division of Fraud Research and Detection - Kathy Oh, Director

Program Integrity Enforcement Group

Margaret Sparr, Director
Western Integrity Field Operations -Suzanne Bradley, Director
Southeastern Integrity Field Operations - Cecilia Franco, Director
Northeastern Integrity Field Operations - Jean Stone, Director

Data Sharing and Partnership Group

Shantanau Agawal, Director
Division of Policy and External Partnership - Toula Bellios, Acting Director
Division of Health Informatics and Systems - Douglas Brown, 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.