Role of the Regional Representative and Backup Regional Representative
Vanessa Templeman; Regional Representatives Chair (AZ)
NAMPI’s primary purpose is to promote communication, information sharing, and mutual support among colleagues responsible for Medicaid program integrity functions within each state/territory that participates in the federal/state partnership program. All 50 states and 6 territories currently participate. With 56 unique Medicaid programs, the challenge for any one organization to be the be-all, end-all for information sharing is significant.
The Regional Representatives serve a critical role for NAMPI. The NAMPI Board includes one appointed position, a Chairperson of the Regional Representatives, to help coordinate across all the regions.
Each of the ten regions (organized by CMS regions, not to be confused with the five UPIC jurisdictions) appoints a Regional Representative to serve for the year as the primary conduit of information to and from the region. The year is measured from the annual conference Regional Roundtable meeting until the following year’s conference Regional Roundtable meeting.
Annual NAMPI Conference Regional Roundtable Meeting
The ”job” consists of fostering communication first at the Regional Roundtable meeting – where typically the current (potentially outgoing) Regional Representative will kick off the meeting with introductions of the participants – who is who and where are they from; feel free to also send away participants who accidentally went to the wrong regions table (it happens) and in some regions the turn-out necessitates breaking the meeting into smaller groups (yeah, lots of attendees) or joining regions to have a more effective discussion.
Typically the Regional Representative is a Program Integrity Director/Manager (or primary point of contact for the state or territory with NAMPI) or senior level manager with the program integrity operations but doesn’t have to be – however, the person needs to have approval from their leadership to hold this position and needs to have the time to do it—in most regions, they try to have a one-hour meeting every month, and then the Regional Representative attends a meeting with the Chairperson of the Regional Representatives and other Regional Representatives for maybe another hour every other month. That’s pretty much the commitment but it’s important that if you volunteer you really can follow through with it. It’s also important that if there are changes to who the Regional Representative is, the Chairperson is notified.
There are really then (typically) only four other responsibilities at the conference’s Regional Roundtable meeting:
(a) elect/debate/volunteer your new (or keep the same) Regional Representative – it is recommended that you do this first so that the new representative can be announced at the conference and so that he or she can take over running the meeting (and ongoing meetings throughout the year) – and this is critical – it is a great idea (thank you to whichever region invented it a few years ago) to also nominate a back-up or co-representative. It gives a representative some help and helps keep continuity should someone leave state service.
(b) discuss/debate/decide how the group wishes to continue communication throughout the year (make a plan about the logistics while you are all there and it’s on your mind); this ongoing collaboration is discussed later in this document/article.
(c) tell the Chairperson of the Regional Representatives who the Regional Representative is (and back-up); if you are able to include contact information right away, that is also very helpful.
(d) now with what little time remains in the roundtable comes the best part – discussions about key issues in your state or territory that are important to you, might be important to others, and are things that you (the region) can and should collaborate on. Whether it’s a discussion of the big data project you are working on or the latest overwhelming fraud scheme you are trying to get a handle on, this is what the session is all about.
For the first time at the conference, we are also going to have a Regional Update agenda item so that each of the Regional Representatives (or the region’s otherwise nominated spokesperson for this conference session) will share memorable discussions and information about schemes and issues for the general membership to all benefit from. So, during the Regional Roundtable, the Regional Representative should take notes (and for that matter so should other attendees) about topics that might be of interest to the other regions – whether its information sharing (e.g., such and such state is working on a project about ABC and has found X, Y, and Z issues) or a need for resources (e.g., so and so in such and such state is looking for any other state or territory with experience in X and would really appreciate if you would contact him or her). This is a chance for the states/territories to be creative, innovative, and collaborative all at once!
Outside-of-the-Conference Responsibilities
The ”job” of Regional Representative primarily includes fostering communication throughout the year for the states/territories within the region – typically holding a monthly (or thereabouts) meeting with the other states’/territories’ lead program integrity personnel. Meetings are typically most effective if there are several participants from each state/territory and if there is some form of a standing agenda so that participants know what is expected at the meetings. The past several NAMPI newsletters have highlighted some of the happenings in the regions – this information comes from the information-sharing that those regions engage in. While there are other working groups that many states participate in – whether with CMS, with other states, federal agencies, Medicaid and/or commercial insurance – the collaboration and communication within the region is the best source of the most applicable information.
The Regional Representatives and the Chairperson make up a workgroup to allow information-sharing across the regions (the Chairperson holds periodic meetings of the Regional Representatives and then the Regional Representatives share that national-level information within their regions) to keep us all informed of happenings around the country. Oftentimes, participants in the regional meetings are not participants in other information-sharing meetings/calls (e.g., the CMS TAG) and so the regional meetings are a great opportunity for everyone to share information from different sources.
Both at the conference and then at the monthly meetings the regional meetings should be discussions about the issues that are most important to you in your regions. Whether it’s sharing the latest fraud schemes by state, or talking about a big case you just won (or lost), it’s really up to you – and because you can do this again, every month or as frequently as you want throughout the year…don’t feel rushed to get in everything you wanted to talk about. A final comment is that the Regional Representatives also serve as the nominating committee for the NAMPI Board. This means that each year before the conference the Regional Representatives should be sharing (within their region) information about what positions on the Board are up for election at the upcoming conference. If there are individuals within the region who are interested in running, that information should be shared across the regions through the Chairperson of the Regional Representatives. Ultimately, if there is more than one person seeking any elected person, an election (a ballot and all) will be held at the conference – one vote per state or territory. It is okay if someone runs unopposed, but it is incumbent upon the Nominating Committee (the Regional Representatives) to solicit additional candidates if they believe having an election (not having someone be uncontested) is in the best interest of NAMPI