State program integrity teams, MCO SIUs, and partners are moving beyond static reporting toward real-time collaboration models that improve visibility and coordination. This panel explores how shared data and centralized platforms are enabling earlier detection, stronger oversight, and more aligned decision-making across the ecosystem.
- How a centralized portal enables real-time information exchange between OIGs, MCOs, SIUs, and partners
- The impact of shared intelligence on identifying high-risk providers and managing overpayments
- How improved collaboration is influencing actuarial processes and managed care rate setting
In partnership with HMS, Gainwell
Brian Dunn
Brian Dunn serves as the Inspector General for the Illinois Department of Healthcare and Family Services, where he oversees program integrity efforts for the state’s $37 billion Medicaid program. In this role, he directs criminal and civil investigations, audits, and compliance reviews, and the data analysis that supports this work. Prior to this, Brian served as First Deputy Inspector General and General Counsel for the City of Chicago’s Office of Inspector General. Before leading government oversight work, Brian’s legal career included serving as the General Counsel for the Illinois Department of Human Services and the Illinois Department of Commerce and Economic Opportunity, a litigation associate for a global law firm, and a law clerk for a federal district judge.
James Vanderberg
James Vanderberg is a Director at HCSC with seven years of experience in the organization’s Special Investigations Department. He currently oversees fraud, waste, and abuse (FWA) operations for government programs.
Prior to joining HCSC, James served with the U.S. Department of Labor, Office of Inspector General, where he retired as the Special Agent in Charge for the Chicago Region. In this role, he led administrative, civil, and criminal investigations involving fraud, waste, and abuse across medical, unemployment, and job training benefits and grants.
Kevin O'Donnell
Kevin O’Donnell is the Director of the Division of Program Integrity for the D.C. Department of Health Care Finance, the District’s Medicaid agency. He has served in that role since November 2021. In that capacity, he oversees the Medicaid agency’s Fraud, Waste, and Abuse activities, coordinating and supervising audits and investigations of Medicaid enrolled providers. To ensure the Medicaid program is effectively rooting out FWA, Mr. O’Donnell collaborates with public and private partners, including law enforcement agencies, regulatory agencies, Managed Care Organizations, and others.
Prior to becoming the Director of the DPI, Mr. O’Donnell spent 7 years as an Attorney-Advisor in DHCF’s Office of the General Counsel, where he defended the agency in administrative appeals before the D.C. Office of Administrative Hearings. Mr. O’Donnell is a graduate of the George Washington University School of Law and a native Washingtonian.
Dr Gary Call
Dr. Gary Call is a board-certified family physician and senior healthcare executive with extensive experience in managed care operations and payment integrity.
Dr. Call is nationally recognized for his leadership in payment integrity and FWA prevention, including advanced analytics, clinical review strategies, and technology-enabled solutions that protect both government and commercial payer programs from improper payments and emerging integrity risks.
As Chief Medical Officer at HMS, Dr. Call oversees Payment Integrity, Care Management, Clinical Analytics, and Population Health Solutions, driving innovation and clinical programs that improve outcomes, strengthen program integrity, and support the financial sustainability of state healthcare programs.