This session will explore how to identify and prevent opioid-related fraud within pharmacy claims, focusing on strategies to combat the opioid crisis while safeguarding healthcare resources.
Helen Liu, Pharm.D.
Helen Liu, PharmD, brings 29 years of diverse pharmacy experience, blending clinical expertise, operational efficiency, technological innovation, and management across various healthcare settings.
Over the past four years, Helen has successfully led pharmacy operations at ATRIO Health Plans (Medicare), achieving significant milestones in PA/ST, FWA, MTM programs, resulting in over $4.5M in savings. She’s conducted formulary analyses to support actuary Medicare annual bid submissions, including IRA and M3P programs, collaborated with partners and the Pharmacy Benefit Manager (PBM) to identify cost-saving opportunities through formulary alternatives, biosimilars, and rebate strategies, and partnered in the RFP PBM selection process and resolved complex pharmacy-related issues through cross-departmental collaboration.
Before ATRIO, Helen spent seven years at Kaiser Permanente, where she served as Regional Assistant Director to implement hospitals Drug Use Management Program. Her efforts led to over $20 million in savings through inventory management, drug cost-saving initiatives, and the standardization of clinical content/practice guidelines.
Anthony Baize
Anthony Baize has been the Inspector General for the Wisconsin Department of Health Services since 2016. He holds a master's degree in public administration from Indiana State University and a Certified Inspector General (CIG) credential from the Association of Inspectors General. Prior to joining Wisconsin state government, Baize was the deputy director of audits and investigations for the Office of the Inspector General for the Kentucky Cabinet of Health and Family Services.
Eric Branson
Eric Branson is a special agent with the Department of Health and Human Services Office of Inspector General. Eric started investigating healthcare fraud in August 2011, spending time at both a Medicare and Medicaid contractor as well as working for the US Attorney's Office in the Middle District of Tennessee prior to becoming an agent. During that time, he has investigated fraud committed against both government and commercial insurance payors perpetrated by doctors, laboratories, pharmacies, home health agencies, durable medical equipment suppliers, and other healthcare providers. Eric graduated from Middle Tennessee State University with a Master's degree in Criminal Justice.