Georgia DCH and Codoxo Take the Stage at NAMPI 2026 to Spotlight AI’s Role in Medicaid Fraud Investigations

Georgia Department of Community Health to co-present with Codoxo on Turning AI-Generated Leads into Actionable Medicaid Fraud Control Unit Referrals

DULUTH, Ga.--(BUSINESS WIRE)--Codoxo, the leading provider of AI and generative AI-powered healthcare payment integrity solutions, announced today that Derik Ciccarelli, the company's Director of Fraud Scope Operations, will moderate a session at the National Association for Medicaid Program Integrity's (NAMPI) 2026 Annual Conference on Monday, August 24, from 10:10-11:10 a.m. PDT in Portland, Oregon.

In the session titled "From AI-Generated Leads to Referral to Medicaid Fraud Control Unit (MFCU): How Program Integrity Investigations Progress from Detection to Credible Allegations of Fraud," Ciccarelli will lead a discussion with Johnny R. Brooks, MPA, CIG, Director of Program Integrity at the Georgia Department of Community Health (DCH), and Sara Rodriguez, CPC, CPIP, Healthcare Fraud Analyst at Codoxo, about real-world investigations from the Georgia DCH. Together, they will examine cases involving alleged identity theft, uncredentialed providers, medically unnecessary equipment, and other fraud schemes across primary care, behavioral health, durable medical equipment, and laboratory services.

The session will also explore how the Georgia DCH collaborated with the Medicaid Fraud Control Unit and other agencies as cases progressed from investigation to referral to state or federal law enforcement. The discussion will emphasize the claims analysis, medical record review, interviews, site visits, and interagency collaboration used to transform AI-generated leads into actionable MFCU referrals.

"AI can surface a lead in seconds, but turning that signal into a credible referral still requires careful investigative work," said Derik Ciccarelli, Director of Fraud Scope Operations at Codoxo. "This session will give program integrity teams a practical view of how real cases are validated, developed, and referred to an MFCU."

The session reflects a broader challenge facing state Medicaid agencies: fragmented systems and disconnected data can make it harder to carry insights from detection through investigation and recovery. Codoxo’s Unified Cost Containment Platform connects pre-claim prevention, prepay review, and post-pay investigation and recovery, helping agencies identify fraud, waste, and abuse earlier and manage payment integrity across the full lifecycle.

Codoxo is a Platinum Sponsor of NAMPI 2026, and attendees can visit the team at Booth #4 throughout the conference to learn more about Codoxo’s Unified Cost Containment Platform and its capabilities across the Medicaid payment lifecycle. For more information, visit nampi2026.vfairs.com.

About NAMPI

NAMPI 2026 is hosted by the National Association for Medicaid Program Integrity and brings together state and federal Medicaid program integrity professionals for case studies and peer-to-peer knowledge sharing on preventing and detecting fraud, waste, and abuse.

About Codoxo

Codoxo empowers healthcare payers with its Generative AI-driven Unified Cost Containment Platform, delivering intelligent, end-to-end payment integrity and fraud, waste, and abuse (FWA) solutions—from pre-claim to prepay and postpay. At the earliest intervention point, Codoxo’s Point Zero Payment Integrity solutions identify and prevent payment errors before claims are even submitted, stopping issues at their source. The platform’s comprehensive AI capabilities span across provider education, data mining, clinical chart and medical record reviews, no-code concept ideation, fraud detection, audit workflow and case management, and provider contract and medical policy compliance. These help payers achieve unmatched accuracy across the entire claim lifecycle. Codoxo’s platform transforms payment integrity by shifting payers from reactive detection to proactive prevention—reducing costs and improving provider relationships. Codoxo has been recognized with a Fierce Healthcare Innovation Award and named to the Inc. 5000 list for its rapid growth. All Codoxo solutions operate in a HITRUST-certified environment. For more information, visit www.codoxo.com.