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Theodore Giovanis, FHFMA, MBA, is the President and founder of T. Giovanis & Company. His experiences include work in government relations, health policy development, and management of health care organizations for more than 30 years. He has been involved in the development of many Medicare regulatory and legislative policy changes such as the creation of the Medicare Geographic Classification Review Board. Mr. Giovanis assists many organizations in developing and executing strategies to capitalize on or respond to government initiated laws and regulations. Mr. Giovanis is a recognized expert in Medicare and Medicaid regulation and has been an expert witness in numerous court cases. Examples of the type of engagements in which Mr. Giovanis has participated include legislative and regulatory advocacy, the evaluation of the reimbursement impact of combining hospitals, the development of health care subsidiaries, assisting compliance officers, securing specialty provider status such as SCH and CAH, and developing home office cost structures and hospital DSH payment reviews.
E-mail : TNGiovanis@AOL.com
J. Graham Atkinson leads many of the firm's engagements involving health policy development. Dr. Atkinson holds a Doctorate degree from Oxford University. He was one of the original developers of the Maryland case mix reimbursement system. He has served as an expert in various court cases and is widely recognized for his health policy expertise. Dr. Atkinson has been involved in the design and development of various RUGs based nursing facility payment systems, APC and APG outpatient payment systems, and the Medicare payment system for ambulance services. He has also been extensively involved in the development of several state rate systems. In addition, he has performed several projects dealing with various Attorney Generals in litigations involving the use of mathematical analyses.
Steven Boucher, MPIA, BA, leads many of the firm's advocacy engagements involving Congress and regulatory agencies. Most of the engagements in which Mr. Boucher participates involve health care providers as they resolve issues with the Medicare and Medicaid programs. Prior to joining the firm, he spent seven years working as the Senior Legislative Assistant in the personal office of a former Committee Chairman in the U.S. House of Representatives. In this position, Mr. Boucher handled a wide range of issues, including Defense, Banking and Finance, Veterans Affairs, and Ways and Means (including Taxes, Social Security, Medicare, and Medicaid). It was in this latter capacity where he became involved from a legislative perspective in many Medicare issues involving payment equity including: issues involving hospital payments, home health care reimbursement, ambulance payment regulations, hospice regulations, area wage adjustments, and metropolitan statistical areas. Mr. Boucher has a Masters degree in Public and International Affairs from the University of Pittsburgh and a Bachelors degree in International Studies from Washington College.
Charlotte Kohler, CPA, LPN, leads many of the firm's engagements in the areas of outpatient, physician, and compliance as well as participating in many inpatient engagements. Ms. Kohler has consulted on a wide variety of engagements such as the evaluation, acquisition, and management of physician practices and outpatient and ambulatory surgery centers. Her work includes the areas of charge master reviews and implementation of Medicare outpatient (APCs). She has served as a compliance officer of a major health system and is a certified appraiser. Ms. Kohler has participated extensively in the design and development of educational programs, many of which are focused on billing and coding issues.
James A. Roark leads many of the firm's reimbursement engagements and works on health policy related matters. He has worked on several projects to enhance provider revenues/payments and assisted with day-to-day financial management, cost report preparation, and third party appeals. His prior experiences include several positions as director or reimbursement for national psychiatric and rehabilitation hospital chains. Accordingly, Mr. Roark has extensive experiences with rehabilitation and psychiatric providers. He has participated in DSH hospital payment engagements and the development of home office structures. From 1992 to 1995, Mr. Roark was a member of the Provider Reimbursement Review Board.
Steven M. Mirin, MD, works with the firm on engagements involving strategic planning and the organization of clinical services for psychiatric hospitals and units. From 1997 through 2002, Dr. Mirin served as Medical Director of the American Psychiatric Association (APA) in
Washington,
DC, overseeing the work of APA staff on all the activities of the Association including legislative and regulatory issues affecting the care of psychiatric patients. During his tenure, APA staff worked with the CMS and others to help shape the development of the new Prospective Payment System for behavioral health care. From 1988 to 1997, Dr. Mirin was president and psychiatrist-in-chief of
McLean
Hospital in
Belmont ,
Massachusetts and a professor of psychiatry at the
Harvard
Medical
School . In that role, he oversaw the hospital's clinical research and teaching mission as well as its daily operations, facilities, and budget. Dr. Mirin is the recipient of numerous awards and honors, including the Presidential Award for Research of the NAPHS, the Founders Award of the
American
Academy of Addiction Psychiatry, and the Administrative Psychiatry Award of the APA and the
American
Academy of Psychiatric Administrators. He is a distinguished fellow of the APA and a member of professional organizations.
Dale Schumacher, MD, MPH, is president and CEO of the Rockburn Institute and assists the firm when the services of a physician are required. Dr. Schumacher is Board Certified in Internal Medicine. His prime expertise is in the area of evidence based medicine, quality measurement, and bench marking. However, he has knowledge of many payment and reimbursement areas and is currently serving in a consulting role as the compliance officer for a multi-hospital system.
Roland King, FSA, MAAA, is a consulting actuary and assists the firm in the areas of managed care and other areas requiring actuarial expertise. Previously, Mr. King served as Chief Actuary of HCFA for fifteen years. In that capacity, he was responsible for preparing financial projections for the Medicare and Medicaid programs, making actuarial determinations affecting the payment and financing of Medicare and developing and determining indices for updating payments. Of particular note is that he was the developer of the AAPCC concept (which is the basis of the Medicare + Choice payments). Mr. King has received numerous awards and is a Fellow of the Society of Actuaries.
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