Joan Senatore, MBA, JD, director of provider compliance at Commonwealth Medicine’s Center for Health Care Financing (CHCF), has received a Distinguished Service Award from the Medicaid Integrity Institute (MII). Established in 2007 by the Centers for Medicare & Medicaid Services and the Medicaid Integrity Group, the MII is a professional development organization that provides state Medicaid program integrity employees with customized training in areas of fraud investigation, data mining and analysis, and case development. One of the first recipients of this award, and a member of the MII faculty since 2008, Senatore was recognized for her contributions to the development of MII curriculum and for her involvement in teaching data reporting classes.
“It is important that program integrity staff stay informed of current trends and receive formal training,” said Senatore. “By doing so, it enables them to more successfully identify fraud, waste and abuse, which helps their state Medicaid offices save money.”
CHCF’s provider compliance unit ensures that MassHealth, the commonwealth’s Medicaid program, meets and exceeds federal requirements for program integrity. As the unit director, Senatore is responsible for the development of Medicaid recovery initiatives, which utilize data analysis and reporting to assess provider regulatory compliance. She also manages the identification of provider fraud, waste and abuse, and improper payments to MassHealth providers.
Prior to joining UMass Medical School in 1996, Senatore was manager of fraud and abuse for the Commonwealth of Massachusetts Office of Medicaid. She also served as liaison to the Medicaid Fraud Control Unit of the Massachusetts Office of the Attorney General, where she consulted on provider fraud issues.
In 2010, Senatore was elected vice president of the National Association for Medicaid Program Integrity (NAMPI), after serving six years as treasurer. An organization that assists states in providing control of fraud or abuse for the national Medicaid program, NAMPI includes attorneys, nurses, contractors, investigators, managed cared staff, managers, pharmacists and others. Senatore is also a member of the board of directors of the Boston chapter of Certified Fraud Examiners and previously served as chapter president from 2001 to 2002.
About the Center for Health Care Financing
Commonwealth Medicine’s Center for Health Care Financing (CHCF) has extensive knowledge of government financing structures that is used to identify savings initiatives for the benefit of its nonprofit and public agency clients. CHCF consultants, who are well-versed in third party liability, program integrity, school-based and federal revenue claiming, analyze human service entitlement programs to identify areas eligible for enhanced or supplemental federal reimbursement.
About Commonwealth Medicine
Commonwealth Medicine (CWM) is the public, nonprofit health care consulting and service organization founded by UMass Medical School. Government agencies, nonprofits and managed care organizations benefit from CWM’s expertise in clinical service delivery, health care financing strategies, policy management and quality improvement. CWM programs have helped Massachusetts—and many other state, international and local health care agencies—to increase the value of health care expenditures while improving access and delivery of care to at-risk and uninsured populations. Commonwealth Medicine programs were developed, in part, as a way for UMMS faculty and staff to have a direct and profound impact on the communities of Massachusetts, and now provide critical opportunities for UMMS faculty and students to serve the community.
CHCF works to improve health care coverage and maximize savings in California
Medicaid Integrity Institute (MII)
Commonwealth Medicine’s Center for Health Care Financing