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 J. Baize is the Inspector General for the Wisconsin Department of Health Services. Baize took the position in early 2016 after eight years with Kentucky state government in the Kentucky Cabinet for Health and Family Services, serving as the Deputy Director of Audits and Investigations for the Office of Inspector General and the Director of Business Informatics with the Department of Behavioral Health, Developmental and Intellectual Disabilities.
Baize has served as the Region V representative for the National Association of Medicaid Program Integrity Directors and on the Advisory Board for the Centers for Medicare and Medicaid Services’ Medicaid Integrity Institute. He regularly speaks at national conferences on topics related to Medicaid Program Integrity.
Baize became a certified inspector general in 2022 after completing the Association of Inspectors General Institute. He is also a member of the Internation Association of Financial Crimes Investigators.
Baize was a civil rights consultant for nearly 20 years, serving on the Board of Directors for the National Fair Housing Alliance and the Lexington (KY) Fair Housing Council. Baize has given presentations on fair housing requirements across the United States, but especially in Kentucky, Indiana, Ohio and Tennessee. He has a master’s degree in public administration from Indiana State University, has been married for 29 years and has two daughters.
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.