Widely recognized as one of the United States’ leading authorities on health care fraud, Bill Mahon is President of The MAHON Consulting Group LLC (MCG), where he specializes in health care fraud detection, management and prevention strategies and services for private and public health insurance payers, law enforcement agencies, the health care professions and health industry organizations in the U.S. and abroad.
Mr. Mahon established an independent consulting practice in July 2004, following a 13-year tenure as executive director and later president/CEO of the National Health Care Anti-Fraud Association.
His areas of expertise and client service include industry anti-fraud practices and benchmarks; comprehensive reviews and enhancements of established anti-fraud operations; risk/exposure assessments for health plans and guidance in their establishment of anti-fraud operations; anti-fraud regulatory compliance and government-affairs counsel; member, customer and provider education; prescription drug abuse and diversion; data-analysis and identification of specific vulnerabilities and
potential frauds; and training for third-party payers, law enforcement and other public-sector agencies.
During his NHCAA tenure, Mr. Mahon testified in many Congressional and state legislative hearings that laid the foundation for today’s statutory and regulatory framework for combating health care fraud. A wellknown speaker and industry instructor, he has made nearly 200 presentations ranging from keynote addresses to focused training sessions to a wide variety of national and international audiences.
A member of the Editorial Advisory Board of Bloomberg/BNA’s Health Care Fraud Report, he also is the researcher and author of Prescription for Peril—a landmark study of the health insurance impact and implications for third-party payers of the nation’s epidemic of prescription drug diversion, published by the Coalition Against Insurance Fraud. Mr. Mahon also is a member of the Expert Panel of the Prescription Monitoring Program Center of Excellence at Brandeis University, funded by the Bureau of Justice
Assistance of the U. S. Department of Justice.
In September 2017, Mr. Mahon was appointed to a two-year term as a member of the U.S. Department of Veterans Affairs Prevention of Fraud, Waste and Abuse Advisory Committee—a Federal Advisory Committee charged with providing related advice and recommendations to the Secretary of Veterans Affairs.
In earlier career experience, he served as a journalist and publishing executive in the financial and health care fields and in several professional political-management positions. A native of Taunton, Massachusetts, he holds a BA degree in Politics from Fairfield University.
Ms Yong is Assistant Director-General of Cyber Security Prevention Program at the Australian Cyber Security Centre. In this role, she advises on cyber security and produces technology risk assessments to secure corporate enterprise networks, national critical infrastructure, system security certifications. She runs the Commonwealth government’s tactical ‘red’ testing teams and is also responsible for Australia’s technology controls policy document known as the ‘Information Security Manual’.
Ms Yong first began consulting in information risk in 2002 at a global audit firm in Sydney. She holds a BA LL.B, Grad Dip Legal Practice and an MBA (Technology) from the AGSM. She is a certified Portfolio Management Office practitioner, a technology assurance specialist and is both a Fellow of the Governance Institute of Australia and a Graduate of the AICD.
Daren qualified as a UK Home Office Investigative Interviewing Trainer in 1996 and has been heavily involved in interviewing witnesses, victims and suspects in connection with a wide range of criminal offences across a number of jurisdictions. He has been teaching as Charles Sturt University’s lead Investigative Interviewing Trainer for 10 years. During his session, Daren will debunk a few common myths surrounding the ‘detection of deception’ and demonstrate how interviewers can reliably increase the chances of exposing deception during interviews with persons who may be inclined to lie or mislead.
Ingrid is a Senior Identity (ID) Fraud specialist in the Department of Human Services’ Operational Intelligence Section. She is responsible for prevention and detection of ID fraud against the department’s programs, including provision of expert advice for new policies, systems and initiatives regarding ID fraud risks.
Ingrid has 19 years’ experience in the Department, with 11 of that in various fraud intelligence related roles. Through her work, she has seen the many impacts ID fraud can have for organisations and individuals. Victims of ID theft not only suffer financial loss, but many devastating health concerns. She has a particular interest in this evolving form of crime and how we can protect citizens and our government.
Isabel has worked in various Investigations and Intelligence roles in DHS since 2010, specialising in Identity Fraud since 2015. Prior to that she was in Customs for 16 years. She is involved in the whole life cycle of Identity Fraud – starting with policy, prevention, digitisation, data capture, detection, intelligence analysis and investigation. Her role is to feed their learnings and experience back into policy areas and new projects/schemes, to ensure their processes evolve in pace with Identity Fraud methodologies.
Isabel is keen to ensure that all citizens, including the most disadvantaged and vulnerable, can access government services by establishing a seamless and secure identity credential.
Professor Quinlivan is Director of the Professional Services Review Agency and a Member of the Administrative Appeals Tribunal of Australia (General and SSCS Divisions). She is a senior consultant in High Risk pregnancy at Canberra Hospital and works in private gynaecology at Barton Specialist Centre.
Professor Quinlivan is a former Pro Vice Chancellor and Executive Dean of Medicine, Dean of Medicine and Dean of Health at the University of Notre Dame Australia. She helped established the Cunningham Centre for Palliative Care Research as a joint initiative of UNDA, UNSW, St Vincent’s Hospital Sydney and LCMHC, has received nearly $10 million in peer reviewed research grants from NHMRC and private sector, and has published over 250 books, book chapters, original research articles and conference proceedings.
Professor Quinlivan has also played a senior role in health services management as a Governing Councillor of North Metropolitan Health Service and subsequently as a Non-Executive Director of South Metropolitan Health Services in Western Australia. She has also played a senior role in the TAFE sector as Deputy Chair and Non-Executive Director of West Coast Institute of Training and subsequently as Non-Executive Director of South Metropolitan TAFE. She was also a former Non-Executive Director of Moreland Community Health Service in Victoria and the WA Sports Centre Trust.
In terms of health care policy, Professor Quinlivan was elected Chair of the Clinical Senate of Western Australia and co-ordinated policy debates on obesity, family violence, homelessness, outpatient care, quality and safety, clinician engagement, patient experience and value in healthcare. An audit demonstrated that 82% of debate recommendations were implemented.
Professor Quinlivan has also played a role in the RANZCOG on various Committees and has taught medical students, junior medical staff and examined for the Australian Medical Council for 20 years.
Martin is attached to the Public Interest Disclosure Team of the Commonwealth Ombudsman’s Office in Canberra and has been in that role since January 2018.
Martin has a background in industrial relations, initially in the Private Sector Division of the Department of Industrial Relations (now Fair Work Ombudsman), which included a secondment to a multi-industry employer association. He later went on to manage the Workplace Relations Division of that employer association and has been the Executive Director of another single-industry employer association. After establishing a boutique industrial relations consultancy primarily assisting Aboriginal Corporations with industrial/employment issues, he was offered managerial roles with two (including an iconic Aboriginal owned and operated substance misuse treatment centre established in 1968) and had to juggle running his own business with running a corporation at the same time. After arriving in Canberra, he completed the ‘trifecta’ of having worked in the IR field for governments, employer associations and employee associations when he was appointed the Senior Industrial Officer for the Australian Federal Police Association.
Before entering the IR field, Martin served a total of 16 years in the NZ Police and NSW Police. As the Dux of his NSW Recruit Course, he underwent the three year prosecutor’s training course and went on to prosecute every crime on the Statutes, from parking offences to murder. Martin also served in Australia’s elite 1st Commando Regiment and in addition to having all the basic air, rock and water qualifications, he qualified as a Military Freefall Paratrooper.
His role at the Commonwealth Ombudsman’s Office is a new initiative and is to explore and suggest alternative resolution mechanisms, other than Public Interest Disclosures.
Paul is a Partner in the KPMG Forensic Practice, specialising in Technology and Cyber Incident Response. Paul has over 20 years of experience in the investigation of technology related offences, starting his career in the UK Police service where he established and led one of the first Computer Crime Units. Since this time, Paul has specialised in the area of Incident Response and Technology Forensics having led responses for some of the world’s largest organisations.
He has provided testimony in a number of domestic and international jurisdictions and acted as an expert witness in a broad range of technology matters.
Paul is regularly engaged by private and public sector clients and their legal advisors on matters that involve:
- The management and investigation of suspected and confirmed cybersecurity incidents.
- The preparation of expert reports regarding electronic evidence.
- The management and delivery of large scale document identification, production and review projects associated with regulatory and compliance investigations.
Peter Kohlhagen is a senior manager in APRA’s policy development area and has been in that role since January 2015. Peter leads APRA’s policy work across the life insurance, general insurance and private health insurance industries.
Peter represents APRA on the Policy Development Committee of the International Association of Insurance Supervisors.
Peter joined APRA in 2005. Prior to his current role has held a range of policy and frontline supervision roles, including supervision of large life insurance companies. He holds bachelor’s degrees in Law and Economics from the Australian National University and a master’s degree in Applied Finance from Macquarie University.
Ray Collins is originally from a law enforcement background having worked as an investigator, intelligence operative and criminal court prosecutor.
In 2003 Ray moved to the UK where he worked in audit and counter fraud within the public health care system (NHS). In the UK Ray also headed up fraud prevention and anti money laundering for Prudentials private medical and life insurance products. As the founder of IMT Ray built and licensed industry data sharing software that connected both public and private health across the UK in fraud prevention. The software connected 41 health insurers with the NHS in preventing fraud within healthcare. It was used within Europe, USA and UAE. IMT also supplied case management software, R&D software , CPD software, fraud investigation, in hospital audit and fraud investigator training to health insurers.
In 2015 Ray sold IMT to Californian health care payment integrity company Performant Corp.
In 2017 Ray relocated to Australia and took up a position with Lorica as a General Manager. In July this year Ray in partnership with a clinician set up Colpec which in its infancy is looking to supply payment integrity to health care payers in Australia.
Simon Cotterell is the First Assistant Secretary of the Provider Benefits Integrity Division in the Department of Health. Simon has worked for over 28 years in government. Over the last 14 years in Health, Simon has led work on health payments integrity; global and regional health issues; drug policy; health financing; health security; the blood supply; organ and tissue donation; and a range of other health system issues.
Prior to Health, Simon worked for a decade as a policy adviser in the Department of the Prime Minister and Cabinet in various areas of social policy and international relations.
Simon has qualifications in political science and economics, and was awarded a Public Service Medal in 2012 for his work on tobacco plain packaging and tobacco control in Aboriginal and Torres Strait Islander communities
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