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Wayne van Halem

Wayne van Halem

PresidentThe van Halem Group

Wayne van Halem founded The van Halem Group in 2006.  The Atlanta-based firm merged with VGM Group in 2014 and Wayne currently serves as its President as they assist providers navigate complex issues related to audits, appeals, enrollment, and compliance. As a CMS contractor for 10 years, he spent a majority of that time as a fraud investigator and national Appeals Director. Wayne is also a published author and well-known lecturer.  He is an Accredited Healthcare Fraud Investigator through the National Health Care Anti-fraud Association (NHCAA); a Certified Fraud Examiner through the Association of Certified Fraud Examiners (ACFE), and an active member of the Health Care Compliance Association (HCCA). He has served on the faculty for each of these national organizations. He also sits on the American Association for Homecare’s Regulatory Council, Medtrade’s Educational Advisory Board, Medicare DME MAC Jurisdiction D Advisory Council, and Board of Directors for Friends of Disabled Adults and Children (FODAC) and the Georgia Association of Medical Equipment Suppliers (GAMES). He has also served as an expert in various criminal and civil proceedings.  Since 2006, his company has saved clients over $150 million in overpayments and denial recoveries.

Wed Mar 24•10:15 AM – 11:15 AM

AI, Algorithms, and Extrapolations in Audit Defense

This session will focus on the most cutting-edge use and abuses of AI and algorithimic software tools and extrapolations by payors and teach suppliers

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This session will focus on the most cutting-edge use and abuses of AI and algorithimic software tools and extrapolations by payors and teach suppliers how to defend and prevent these types of audits. This session will also cover current litigation on

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This session will focus on the most cutting-edge use and abuses of AI and algorithimic software tools and extrapolations by payors and teach suppliers how to defend and prevent these types of audits. This session will also cover current litigation on key legal issues and developments in the laws surrounding the use of AI and algorithimic tools and sampling and extrapolation. 

This session will focus on the most cutting-edge use and abuses of AI and algorithimic software tools and extrapolations by payors and teach suppliers how to defend and prevent these types of audits. This session will also cover current litigation on key legal issues and developments in the laws surrounding the use of AI and algorithimic tools and sampling and extrapolation. 

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Audits, Compliance, Provider Enrollment & AccreditationSession Track
Stephen Bittinger
Stephen BittingerShareholder, Polsinelli, PC
Wayne van Halem
Wayne van HalemPresident, The van Halem Group
Tue Mar 23•1:00 PM – 2:00 PM

CMS Fraud, Waste, and Abuse (FWA) Efforts and Impact on DMEPOS Suppliers

This session will provide an overview of the current federal fraud, waste, and abuse landscape and explain how initiatives from CMS influence day-to-d

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This session will provide an overview of the current federal fraud, waste, and abuse landscape and explain how initiatives from CMS influence day-to-day supplier operations. Attendees will gain a better understanding of recent enforcement trends, eme

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This session will provide an overview of the current federal fraud, waste, and abuse landscape and explain how initiatives from CMS influence day-to-day supplier operations. Attendees will gain a better understanding of recent enforcement trends, emerging compliance expectations, and practical steps to help reduce risk while maintaining compliance in an increasingly complex regulatory environment.

This session will provide an overview of the current federal fraud, waste, and abuse landscape and explain how initiatives from CMS influence day-to-day supplier operations. Attendees will gain a better understanding of recent enforcement trends, emerging compliance expectations, and practical steps to help reduce risk while maintaining compliance in an increasingly complex regulatory environment.

Show MoreClick the title to see all details
Audits, Compliance, Provider Enrollment & AccreditationSession Track
Wayne van Halem
Wayne van HalemPresident, The van Halem Group
Mina Uehara
Mina UeharaSenior Director, Regulatory Affairs, American Association for Homecare
Wed Mar 24•3:15 PM – 4:15 PM

Medicaid Audits

Audits, Compliance, Provider Enrollment & AccreditationSession Track
Wayne van Halem
Wayne van HalemPresident, The van Halem Group
Laura Williard
Laura WilliardSVP, Payer Relations, AAHomecare