Washington Update: Where Do We Go From Here?

Audience

senior leadership, clinical leadership, and health care leaders in hospitals and health systems

Overview

A new administration has taken over in Washington, D.C., during a national health crisis. This session will highlight the primary goals for President Biden and his new Cabinet members, Xavier Becerra, U.S. Secretary of Health and Human Services, and Elizabeth Richter, Acting Administrator of the Centers for Medicare & Medicaid Services, as well as the status of each as we enter into late summer of 2021. This program also will provide the dynamics of the changes that are finalized by CMS for federal fiscal year 2022, which will take effect Oct. 1, 2021.

Learning Objectives:

• • become familiar with our new leaders in Washington, D.C., and their priorities related to combatting the COVID-19 pandemic
  • obtain knowledge on legislation, such as the Affordable Care Act, The Consolidated Appropriations Act and The Resident Physician Shortage Reduction Act of 2021
  • explain CMS’ final payment and policy changes for FFY 2022 as they relate to the Medicare Inpatient Prospective Payment System

Speakers

Larry Goldberg has more than 45 years of health care finance knowledge. He is a well-known and recognized expert on Medicare payment issues and frequently makes speeches to groups regarding federal payment legislation and regulations, and the ever-changing perspectives in Washington, D.C., regarding health care.

Goldberg retired as director of Deloitte and Touche's Washington National Affairs for Health Care office in June 2006. He served as the firm's "listening post" on federal — Medicare and Medicaid — health care financial issues, and assisted firm practitioners and clients on health care financing issues for more than 22 years. At Deloitte, he wrote the firm’s well-known and respected Washington Commentary and Health Care Review publications. Upon retiring, he formed Larry Goldberg Consulting. He currently assists several state hospital associations and Third Party Reimbursement Solutions, LLC. Goldberg continues to write and provide to clients his Washington Perspectives, analyzing changes in Medicare legislative and regulatory payments.

Michael Polito formed Third Party Reimbursement Solutions, LLC in April of 2008. TPR has evolved into a national consulting firm and provides full-service Medicare and Medicaid reimbursement services. The cornerstone of our growth and success lies within the strategic hiring of high-level and experienced regulatory personnel, in addition to employing a robust data and technology department.

Before creating TPR, Polito served as a health care director out of the Charlotte, N.C., office at PricewaterhouseCoopers, LLP. His experience includes 11 total years at PwC, at which time he focused on hospital regulatory payment issues, client services and product/business development.

While with PwC, he directed the preparation and analysis of numerous cost reports for a wide range of facilities, including acute care hospitals, home offices, rural health clinics, home health agencies and outpatient rehab facilities. Polito also reviewed financial statement estimates, contractual reserve adjustments and performed due diligence services for a wide variety of clients. He successfully developed a Medicare wage index assessment program, and a methodology to identify Medicaid eligibility days for inclusion in the Medicare Disproportionate Share calculation, both of which have been adopted by PwC on a national level.

Polito has directly managed in excess of 350 Disproportionate Share engagements that have generated more than $230 million in additional reimbursement for his clients. In addition, he has been directly responsible for the delivery of more than 600 Medicare wage index projects, which has generated in excess of $200 million of revenue for his clients.

Tracey Roland is a Principal at Third-Party Reimbursement Solutions, LLC. Before joining TPR in 2018, she was the founder and served as President of INTEGRITY Regulatory and Reimbursement Services, LLC for 10 years.

Roland has more than 25 years of health care financial experience, with an extensive background in revenue enhancement and federal and state regulatory issues for hospitals and health systems. Before starting her own company, Roland worked for eight years for Ernst & Young LLP. She served as the regulatory practice leader in their Hartford, Conn., and Iselin, N.J., offices.

Roland was credited for developing E&Y’s national Medicare wage index services and she also served as a lead instructor for the E&Y’s reimbursement and compliance courses. She is a frequent presenter at both northeast and national health care conferences. She reviews and prepares Medicare and Medicaid cost reports, performs hospital consolidation and acquisition analyses, evaluates federal and state reimbursement, and files appeals and reopening requests.

Roland represents hospitals in negotiations with third-party intermediaries during the entrance and exit conferences and throughout the appeal process. In addition, she has served as a liaison between her health care clients and Congress.

This educational activity is provided by MHA Health Institute.