Today, I am a nationally-recognized expert in the American Medicare and Medicade programs – but the journey to this step began 30 years ago.

Early in my career, I was a rate setter and developer of the Maryland rate-setting system at the Maryland Health Services Cost Review Commission.

In this role, I was involved in the rate-setting policy development and set rates for all the hospitals in the state. This was the beginning of my involvement in the health policy arena. After five years I went back into the hospital setting when I became the Director of Regulatory Services for my professional association the – Healthcare Financial Management Association (HFMA).

In this capacity, I was heavily involved in all Medicare regulatory development and much of the Medicare legislation spawned by Congress. I was also involved in the tax issues in tax-exempt entity spectrum.

After my time at HFMA, I moved to be the Director of Healthcare at Touche Ross (TR) in the firm’s Washington Service Center. As the firm’s point person on healthcare issues in Washington D.C. I was very heavily involved in all healthcare issues for the firm and supported the healthcare practice.

I interacted with many of the firm’s larger health system clients, including Kaiser Permanente and other larger clients such as Sears. I also was the firm’s representative on the US Chamber of Commerce’s Health and Employee Benefits Committee. In addition, I was involved in many of the health regulatory policy development and also legislations from Congress.

In 1991, I elected to leave TR and started my own health policy regulatory and consultancy.

My firm represented a wide variety of hospitals and health systems with Medicare (generally the acute care payment system for the elderly) and Medicaid regulatory matters (generally a federally regulated joint federal and state program for health services for the poor) and developed several major Medicare policy programs on behalf of clients.

In this capacity, I have lobbied Congress on many matters that led to the creation of many Medicare payment adjustments, including:

the creation of the Medicare Geographic Reclassification Review Board, a legislatively targeted Medicare labor adjustment (Section 152); a group legislatively targeted Medicare labor adjustment ultimately extended for approximately a decade (Section 508); the Medicare Dependent Hospital Adjustment provision (a program for small rural, heavily Medicare-dependent hospitals);
the Medicare Psychiatric Hospital payment system and others.

I became a nationally recognized expert in Medicare issues and specifically, the Area Wage Index (an adjustment for geographic wage differentials), and have testified in many court cases as a Medicaid payment policy expert.

My understanding of public health policy has continued to evolve over the past three decades, and am presently involved in and monitor Congress and the regulatory bodies for Medicare, Medicaid, the Food and Drug Administration (FDA), the Center for Disease Control (CDC), and others.