ATC 2025 Session Takeaways
Integrity Advantage was excited to return to the National Health Care Anti-Fraud Association’s (NHCAA) Annual Training Conference (ATC) at the end of last year, held November 18-21 in Nashville. As always, the energy of ATC was unmatched. Our team spent the week meeting new partners, reconnecting with colleagues, learning from thought-provoking sessions, and engaging in meaningful conversations about the evolving challenges and opportunities within healthcare fraud, waste, and abuse (FWA).
While we did not present this year, we proudly sponsored a booth in the vendor hall. Our newly refreshed set up gave us the perfect backdrop to meet with FWA program leaders, investigators, medical reviewers, and others from across the country. The insights shared, stories exchanged, and relationships strengthened throughout the week left us inspired and energized as we closed out 2025 and kicked off the new year.
With so much valuable content packed into the agenda, several themes clearly emerged. Here are our biggest takeaways from ATC 2025.
Centers for Medicare & Medicaid Services’ (CMS) Commitment to Fighting Fraud
The keynote speech delivered by Kimberly Brandt, Chief Operating Officer and Deputy Administrator of Centers for Medicare & Medicaid Services (CMS) set a positive and energizing tone for the conference. Brandt emphasized CMS’s strong commitment to aggressively “crushing” FWA, pointing to recent high‑profile cases, such as the misuse of skin substitutes, as clear examples of the agency’s renewed focus.
Brandt stressed that historically high reimbursements for skin substitute products created incentives for overbilling, often without sufficient clinical justification or proper documentation. Her remarks reinforced that CMS not only recognizes these patterns but has already taken steps to address emerging and ongoing FWA risks.
The keynote also underscored the constantly evolving nature of healthcare fraud. As bad actors develop new schemes, regulators, health plans, and other stakeholders must continuously adapt by closing loopholes and responding swiftly to shifting vulnerabilities.
Based on Brandt’s insights, organizations should anticipate sustained and increasing attention and resources from CMS dedicated to the prevention, detection, and enforcement of healthcare FWA.
One facet of CMS’s efforts, as discussed by Brandt, relates to the expanding role of artificial intelligence (AI). The Crushing Fraud Chili Cook-Off Competition was well underway at the time of ATC 2025, with challenge participants proposing ways to leverage machine learning (ML) models to detect anomalies and trends in claims data to uncover FWA.
The AI Double-Edged Sword; Powering Detection and Enabling Abuse
AI was at the center of many subsequent conversations and sessions during the conference. AI is becoming a powerful asset not only in preventing healthcare FWA but also, alarmingly, in perpetrating fraud. Sessions explored how modern AI tools are enabling investigators to analyze vast data sets and flag suspicious patterns more quickly and efficiently.
At the same time, speakers emphasized the unsettling advances fraudsters may harness. From fabricating medical records to facilitating identity theft, AI is making illicit schemes more plausible, more scalable, and harder to detect. The conference made clear that as fraud-fighting capabilities rise, so do the sophistication of the bad actors.
Collaboration Is Critical
A recurring theme throughout ATC was collaboration, not just within single health plans or companies, but across payers, investigators, and other stakeholders. During the awards ceremony, the case honored as “SIRIS Investigation of the Year” exemplified this. As many know, NHCAA’s Special Investigation Resource and Intelligence System (SIRIS) enables users to share information about their investigations with other users.
The case that achieved this award at ATC 2025 succeeded because of the ability of multiple entities to connect and pool investigative insights. The result: a comprehensive, multi-plan investigation that would have been impossible without cross-organization cooperation. This strongly reinforced the idea that combatting fraud is not a siloed effort; it requires shared vigilance, open communication, and coordinated resources across the industry.
Integrity Advantage is grateful to be a part of the collaboration that attending ATC affords, as we share our insights and learn from our fellow fraud fighters in the industry.
Bringing FWA Into Focus: Our Booth & Top Focus Areas
Integrity Advantage New Booth Set Up!
ATC 2025 gave the Integrity Advantage team the perfect opportunity to debut our refreshed booth. Complete with a new backdrop, the booth’s theme centered on helping plans bring their FWA programs into focus. When you’re deep in the day-to-day work, it’s easy to miss what’s right in front of you. Sometimes all it takes is a fresh set of eyes to reveal blind spots, surface new risks, and sharpen strategic priorities.
Attendees stopped by to chat about their programs, grab some of our always-popular swag (the nail files continue their legendary status), and pick up copies of our latest articles. This year Integrity Advantage also introduced a new freebie for attendees, which was a sunglass/glasses case printed with “I don’t stalk, I investigate.” This was clearly a new fan favorite. Of course, our #FreeTheSIU stickers made their annual appearance, sparking conversations about elevating SIU voices within payer organizations.
Integrity Advantage also launched a fun new giveaway: conference attendees shared their top three FWA focus areas for 2025. The insights contributed were thoughtful, honest, and incredibly valuable to ongoing conversations about how to improve FWA efforts and yield successful outcomes. These included topics like training, fraud detection, and data analytics.
To everyone who stopped by the booth, grabbed swag, shared their perspectives, or joined us at our event, thank you. Integrity Advantage is grateful for the conversations, collaboration, and commitment you bring to the fight against healthcare FWA.
We look forward to seeing you later this year at ATC 2026!
Integrity Advantage is the way healthcare payers reimagine the value of their fraud, waste and abuse program. We provide FWA services to payers around the country.
If you need a program assessment, program growth strategy, investigations, medical reviews or training support -- reach out today.
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