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Center for Program Integrity

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

Jonathan Morse, Deputy Policy Director

George Mills, Jr., Deputy Operations Director

State Liaison Staff

Douglas Brown - Acting Director

Business Services Group

Teresa Krause - Director

Provider Enrollment and Oversight Group

Zabeen Chong, Director
Division of Enrollment Systems - Richard Gilbert, Director
Division of Enforcement Actions - Vacant, Director
Division of Enrollment Operations - Alisha Banks, 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, Director

Data Sharing and Partnership Group

Douglas Brown, Director
Division of Stakeholder Engagement and Outreach - Toula Bellios, Director
Division of Data and Informatics - Robin Usi, Director

Investigations and Audits Group

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

Contract Management Group

Craig Gillespie, Director
Division of Contract Management - John Webster, Director
Division of Contractor Performance and Assessment - Olivia Williams, Director
Division of Acquisition Strategies and Planning - Kenneth Fleet, Director

Governance Management Group

Mary Greene, M.D., Director
Division of Vulnerability Governance - Crystal High, Director
Division of Policy and Regulations - John Spiegel, Director
Division of Performance and Oversight - Samantha Richardson, 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.