Edward C. Crooke, assistant director, civil division, fraud section, United States Department of Justice, will return to RISE National to offer his perspective on enforcement of fraud in the Medicare Advantage program.
Crooke, who spoke last year during a popular session about the False Claims Act and the consequences of financial fraud, will describe the statutory and regulatory tools available to the government in investigating and pursuing fraud on the Medicare Advantage program, including liability of individuals and vendors. He will provide an update on the application of the False Claims Act to unlawful business practices involving Medicare Advantage plans, providers, and vendors.
He will also highlight recent settlements and ongoing enforcement actions pending in federal court.
His keynote presentation will take place at 10 a.m. Thursday, March 13.
Crooke will join a roster of more than 100 speakers, including six representatives from the Department of Health and Human Services (HHS) Office of Inspector General (OIG).
RELATED: 6 OIG reps confirmed as speakers at RISE National 2025
Ann Maxwell, the deputy inspector general for evaluation, will share her vision for cultivating trust in Medicare Advantage during her keynote presentation. Later, a panel of speakers from the OIG will discuss recent and ongoing audits and evaluations of Medicare Advantage plans that continue to raise concerns about the accuracy of risk adjustment data and payments. They will also review compliance issues for managed care and examine recent fraud cases and trends.
The two remaining keynote speakers previously announced are Justin Wren, elite UFC/MMA fighter turned global humanitarian and founder of Fight for the Forgotten, and Dr. Robby Sikka, NBA physician and health innovator,
Wren, in a presentation sponsored by Inovalon, will explore the power of service, the profound difference we all can make in the lives of others, and the ripple effect that extends far beyond what we can imagine–including the transformation that occurs within ourselves when we choose to live purposefully and serve selflessly.
Dr. Sikka, who previously served as the associate director of data analytics at the Mayo Clinic and was a senior consultant to Tonal, Oura Ring, Pacaso, will address how to use artificial intelligence and compassion to address the aging population’s unique challenges.
RISE National will take place March 11-14 in San Antonio. Click here for the full agenda, roster of speakers, and registration information