Bob Mays is Staff Vice President for Anthem, Inc.’s Special Investigations Unit (SIU). He has decades of experience in the management and direction of benefit integrity operations, including over 27 years in management positions, 20 years in law enforcement, and 17 years in health care fraud, investigations, and analytics. Bob’s vast previous experience includes over 20 years as the Deputy Chief of Police for the Dover, Delaware Police Department overseeing all aspects of the department including responsibility for coordinated joint operations with DEA, FBI, IRS, ATF, and U.S. Secret Service involving fraud and seizure of assets. He has comprehensive experience leading multiple site operations, managing multi-million dollar budgets, and running large teams.
Bob graduated from the FBI National Academy (FBINA) and is still involved in the FBINA Associates. Bob is an Accredited Healthcare Fraud Investigator and a Certified Fraud Examiner. He currently serves on the Board of Directors for the National Health Care Anti-fraud Association (NHCAA), and is a recipient of the FBI Directors Award for distinguished public service in healthcare fraud.
Bob is Anthem’s lead for the detection and prevention of healthcare fraud, waste, and abuse (FWA) in its Medicare, Medicaid, and Commercial programs. Anthem’s SIU under Bob’s leadership has over 300 associates comprised of investigators, analysts, medical professionals, and management conducting thousands of investigations annually to protect Anthem’s members, customers (comprised of federal, state, and commercial clients), and company. Under his leadership, Bob’s team has produced significant increases in business and government savings.
Anthem’s SIU team is trained to combat fraud and abuse utilizing a range of innovative strategies that leverage data mining and analytic capabilities. Anthem SIU uses these capabilities not only to identify and address instances of prescription drug waste, fraud, abuse, and diversion, but also to closely monitor claims for potential fraudulent or abusive behavior. Notably, Anthem’s FWA programs are consolidated under Bob’s leadership across all of Anthem lines of business in order to maximize daily proactive claims data analysis and mitigate an increasingly greater number of FWA activities.