By Lindsey Rodarmer, MS, Public Relations Manager, Acentra Health
LinkedIn: Lindsey Rodarmer, MS
LinkedIn: Acentra Health
Our Acentra Health team returned from the 2026 National Association of Medicaid Program Integrity (NAMPI) Annual Conference with a renewed appreciation for the people and partnerships working to protect Medicaid and strengthen outcomes nationwide.
Held August 23–26, in Portland, Oregon, NAMPI 2026 brought together more than 1,000 professionals from state and federal agencies, Medicaid Fraud Control Units, managed care organizations, law enforcement, and industry. The conference created a collaborative forum for examining how Medicaid programs can prevent, detect, and address fraud, waste, and abuse while supporting access to high-quality care.
For Acentra Health, the conversations with our team members in Booth 17 reinforced an important message: effective Medicaid oversight depends on more than identifying improper payments after they occur. It requires connected data, proactive oversight, strong investigative practices, and technology that helps agencies act with greater speed and confidence.
From reactive detection to proactive prevention
One of the strongest themes throughout the conference was the continued shift from reactive fraud detection toward prevention.
NAMPI 2026 sessions explored how states can strengthen program integrity at the front door through provider screening, eligibility verification, risk-based oversight, and prepayment review. By identifying potential risks earlier, Medicaid agencies can protect public resources while reducing the administrative burden associated with downstream investigations and recoveries.
This preventive approach requires reliable data and flexible technology. When provider, member, claims, financial, and investigative information can be connected across systems, agencies are better positioned to recognize patterns, prioritize risk, and intervene before vulnerabilities become larger problems.
Turning data into actionable intelligence
The conference highlighted the growing role of data analytics, financial forensics, artificial intelligence, and new data connections in Medicaid compliance and accountability initiatives.
Technology can help agencies surface relationships and patterns that may not be visible through manual review alone. However, technology is most effective when paired with experienced analysts, investigators, auditors, clinicians, and program leaders who can interpret findings and determine the right course of action.
The goal is not simply to collect more information. It is to transform data into actionable intelligence that supports faster investigations, more targeted audits, better coordination, and stronger decision-making.
This balance between advanced technology and human expertise, or, keeping a human in the lead, as Acentra Health refers to it, was reflected in discussions about generative AI, analytical tools, financial intelligence, and investigative partnerships. Responsible implementation remains essential, with attention to transparency, privacy, governance, and defensible outcomes.
Strengthening audits and oversight
Several conference sessions focused on the operational and legal foundations of effective program integrity, including audit protocol development, appeals, managed care oversight, eligibility audits, and improper-payment reviews.
These discussions underscored that strong outcomes are shaped well before an audit finding or investigation is completed. Clear protocols, consistent documentation, stakeholder input, and fact-based decision-making help agencies build processes that are both effective and defensible.
As Medicaid programs continue to evolve, states must also coordinate oversight across fee-for-service and managed care environments. That requires shared standards, integrated workflows, and visibility across the broader Medicaid enterprise.
Collaboration remains the foundation
NAMPI 2026 also demonstrated the importance of collaboration across state and federal agencies, Medicaid Fraud Control Units, managed care organizations, law enforcement, and technology partners.
The conference included dedicated forums on investigative intelligence, data access, interstate provider tracking, and cross-entity coordination. These conversations reflected a broader understanding that fraud, waste, and abuse initiatives cannot stop at jurisdictional or organizational boundaries.
This collaboration starts with procurement. State and federal agencies must hold managed care organizations and technology partners responsible for continuous modernization. Decades-old systems are incapable of harnessing today’s innovative solutions to prevent fraud, waste, and abuse. Vendors and partners must commit to fair procurement processes, awards, and meeting requirements to evolve. Cloud-native solutions and configurable, interoperable systems are critical to supporting prevention.
Effective program integrity depends on the ability to share information, align priorities, and learn from one another. Peer-to-peer discussions and real-world case studies offered practical insight into how agencies are addressing challenges such as personal assistant fraud, dental fraud, behavioral health services, provider vulnerabilities, capitation recovery, and improper payments.
Preparing for what comes next
Medicaid agencies are navigating increasing complexity, evolving federal expectations, workforce challenges, and pressure to demonstrate measurable value. At the same time, program integrity leaders are being asked to modernize operations without compromising fairness, access, or due process.
The conversations and connections our team experienced at NAMPI 2026 made clear that the future of integrity operations will be more connected, data-driven, proactive, and person-centered.
As Vanessa Templeman, NAMPI President and Inspector General, Office of Inspector General, Arizona Health Care Cost Containment System said in the conference welcome:
“The work ahead will require endurance, discipline, and a willingness to act before others see the opening; qualities that often determine who reaches the finish line first.”
The work of protecting Medicaid is shared work. By combining trusted partnerships, actionable intelligence, and modern technology, states can strengthen program integrity while preserving resources for the people and communities Medicaid is designed to serve.