MYERS AND STAUFFER - Key Persons
Allan is one of the partners-in-charge of the Pharmacy engagement team. Since joining Myers and Stauffer in 1997, he has managed a variety of projects including pharmacy consulting, program integrity, litigation support, and rate setting engagements.
He has played a significant role in pharmacy reimbursement consulting engagements with numerous state and federal clients. He has advised state Medicaid programs regarding pharmacy dispensing fees, and managed dozens of pharmacy cost of dispensing surveys. Allan has also been involved in the firm's pharmacy ingredient cost studies, State Maximum Allowable Cost (SMAC) projects and Average Acquisition Cost (AAC) engagements including Myers and Stauffer's contract with the Centers for Medicare & Medicaid Services (CMS) to develop and maintain the National Average Drug Acquisition Cost (NADAC) benchmark.
Since 2003, Allan has managed the firm's project to perform program integrity audits of Medicaid providers for the Alaska Department of Health and Social Services. This project involves the analysis of Medicaid claims data from all providers, the selection of providers for desk review, as well as additional on-site review procedures. Under his direction, the project team collects clinical and other documentation for audit from a set of sampled claims. The team reviews the documentation and applicable policies to determine if the provider's billings are appropriately supported. Additionally, Allan provides expert testimony on behalf of the state client when reported overpayments are appealed by the audited providers.
Allan has also assisted with a number of other Medicaid reimbursement consulting engagements including rate setting for home and community-based services (HCBS), mental health services, hospital reimbursement through diagnosis-related groups (DRG), and physician reimbursement through Resource-Based Relative Value Systems (RBRVS).
Amy has been with the firm since 1991 providing consulting and public accounting services to more than twenty state Medicaid agencies regarding health care reimbursement issues. She is a member of the firm's Executive Committee. She is also involved in the firm's nursing facility rate setting, hospital reimbursement, and upper payment limit practice areas.
Over nearly 30 years Amy has been with the firm, she has assisted State Medicaid agencies in the development, implementation and maintenance of nursing facility rate setting systems, including case mix and fair rental value, inpatient hospital prospective payment systems based on diagnosis resource groups (DRGs), and outpatient hospital prospective payment systems based on ambulatory payment classifications (APCs)/ambulatory patient groups (APGs). She also serves as project director for the preparation of Medicare upper payment limit (UPL) determinations and ensuring states are in compliance with federal requirements for several of the Firm's state Medicaid agency clients.
In 2004, Amy established the firm's Des Moines, Iowa office and hired and trained approximately 15 staff including CPAs, CPA candidates, computer professionals and accounting technicians. She continued to manage the office of 30+ staff through 2012 and currently serves as the partner in charge of the office. During her time at the Iowa Medicaid Enterprise she was instrumental in assisting the state implement provider tax programs, certified public expenditure and intergovernmental transfer programs, enhanced disproportionate share programs, and Iowacare, an 1115 Medicaid demonstration project that expanded eligibility for the Medicaid population.
Her experience also includes policy research and data analysis, preparing fiscal impact models, presenting policy changes to providers, stakeholders and legislators, drafting state regulation and state plan language, and Medicaid cost report reviews across both institutional and non-institutional health care services.
Amy is a Certified Public Accountant and a member of the American Institute of Certified Public Accountants and the Kansas Society of Certified Public Accountants as well as multiple state Societies of Certified Public Accountants.
Amy has more than 30 years of experience in professional marketing services for the accounting, architecture, and education industries. Since 1998, she has led Myers and Stauffer's marketing efforts, which balances writing winning government proposals with enhancing internal and external communications that define and articulate the firm's competitive strengths.
Under her leadership, the marketing communications team rebranded the firm in 2012, launched its first intranet in 2016, reimagined the external website in 2019, and introduced a customer relationship management database in 2021. The marketing team manages the firm's presence at more than 10 national conferences annually, with our professionals on many agendas as speakers and industry thought leaders. The proposal development team works with subject matter experts throughout the firm and responds to more than 150 proposals annually. They have maintained an approximate 70 percent success rate for more than 20 years.
Amy has spoken at annual conferences for the International Association of Business Communicators (IABC) conference in 2013 and the Association of Proposal Management Professionals Bid & Proposal Con in 2017. Under her leadership, Myers and Stauffer won a Gold Quill award from IABC in 2018 for development of the firm's intranet and a Bronze Quill award for our internal core values campaign.
Job Titles:
- Certified Public Accountant
- Partner
Andy is a partner-in-charge of our Pharmacy engagement team out of our Baltimore office. For more than 20 years, he has been performing health care and government-related audit and consulting engagements for Myers and Stauffer.
Andy has led Medicaid, Medicare, and other governmental health care audits related to a variety of provider types, including nursing facilities, pharmacies, health plans, and pharmacy benefit managers (PBMs). These engagements have been performed for Medicaid agencies, the Centers for Medicare & Medicaid Services (CMS), state employee benefit programs, and other governmental agencies. His areas of expertise include Medicare Parts C and D, pharmacy, program integrity, risk assessments, and Medicare/Medicaid reimbursement.
For the past 15 years, Andy has focused on providing oversight of managed care organizations (MCOs) and PBMs. These engagements include performing financial audits, compliance audits, performance audits, program integrity reviews, benefit audits, and demonstration program reviews. He also supports federal law enforcement in performing damage calculations, and has testified in federal health care fraud cases.
Andy is a Certified Public Accountant and a member of the Maryland Association of Certified Public Accountants, the American Institute of Certified Public Accountants, Health Care Compliance Association, and the National Health Care Anti-Fraud Association.
Job Titles:
- Certified Public Accountant
- Partner
- Project Manager
- Member of Our Firm
Ashleigh is the partner-in-charge of the firm's Denver office. With more than 15 years of experience, she manages auditing engagements of various health care provider types, and provides consulting services for the Colorado Department of Health Care Policy & Financing. She oversees the performance of field examinations and desk reviews for community mental health centers, nursing facilities, intermediate care facilities, hospitals, federally qualified health centers, and rural health clinics in accordance with Generally Accepted Auditing Standards, as well as state Medicaid regulations. Her responsibilities include assigning staff, supervising job performance, and reviewing documents to assure compliance with contracts and performance specifications. Ashleigh attends stakeholder meetings with the Department and provider representatives, wherein she provides data analysis and consulting services, as requested. She works with the Department to evaluate reimbursement methodologies and policies and provides presentations to various stakeholder groups on reimbursement and audit methodologies.
Ashleigh also serves as the project manager for the firm's Colorado Electronic Health Records Incentive Program payment review engagement. She oversees the on-site and desk reviews of eligible professionals and eligible hospitals participating in the Colorado Medicaid incentive program, assists the Department during the informal reconsideration and appeals processes, and is responsible for the development and updating of the audit guide used by the state of Colorado to seek approval from CMS to administer the Medicaid incentive program.
Ashleigh is a member of our firm's Quality Control leadership team. She is responsible for developing quality control policies and procedures in accordance with professional standards, and consulting with engagement teams to ensure high quality products are the standard of business. She collaborates with other members of the leadership team to evaluate changes to professional standards that impact our work, and to develop an implementation and communication plan to integrate changes.
Ashleigh is a certified public accountant and a member of the American Institute of Certified Public Accountants, the Colorado Society of Certified Public Accountants, the National Association of Certified Fraud Examiners, and the Colorado chapter of the Association of Certified Fraud Examiners.
Job Titles:
- Certified Public Accountant
- CFF
- CFF, CFE, CHPS, CHPC / Member
Beverly is an industry-leading expert in managed care compliance auditing, performing health plan operational assessments; encounter data accuracy and other managed care program compliance engagements; fraud and abuse detection; and developing audit strategies across all health plan and provider types. She also serves as a subject matter expert for engagement-related health care data privacy and security concerns. Beverly serves as the firm's Privacy Officer.
Beverly's three decades of broad experience include, among other things, analysis of financial and utilization data, analyses of the health plan business models, fact finding interviews, on-site procedures, and contract analyses. She is a leader in the firm's Medicaid managed care practice area where her responsibilities include consulting on monitoring and reporting of health plan compliance with contractual and regulatory provisions, encounter data completeness and accuracy assessments, external quality reviews, on-site financial audits, and other reconciliations. She also provides technical expertise on various program integrity engagements including post-payment review of claims and fraud, waste, and abuse detection. She communicates with and serves as a liaison to providers and professional associations, oversees the preparation of written and oral reports, and regularly presents to the state agencies and stakeholders.
Beverly is a Certified Public Accountant (CPA), Certified in Financial Forensics (CFF), a Certified Fraud Examiner (CFE), Certified in Healthcare Privacy and Security (CHPS), and is Certified in Healthcare Privacy Compliance (CHPC). She is a member of the American Institute of Certified Public Accountants, the Association of Certified Fraud Examiners, the Indiana CPA Society, the Kentucky Society of Certified Public Accountants, the Georgia Society of Certified Public Accountants, the Healthcare Financial Management Association, the Healthcare Compliance Association, and the American Health Information Management Association.
Bob is the partner-in-charge of our Baltimore office and is a member of the firm's executive committee. He also serves as the firm's Chief Compliance Officer. For more than 30 years, he has provided health care-related audit and compliance services to state Medicaid agencies and the federal government.
Throughout Bob's career, he has performed audits and desk reviews of health care providers throughout the country. Bob's clients have included the states of Maryland, Montana, North Carolina, South Carolina, and Virginia. Bob also has experience overseeing audits of pharmacy benefit managers (PBMs) and third-party administrators (TPAs).
More recently, Bob has devoted his practice to assisting states and the Centers for Medicare & Medicaid Services (CMS) with oversight of managed care organizations. Since 2005, Bob has worked with CMS, overseeing various contracts with the Division of Capitated Plan Audits, Medicare Part C and D Oversight and Enforcement Group (MOEG), Office of the Actuary, and the Office of Research, Development, and Information. Bob's work for the Division of Capitated Plan Audits has included examinations of financial information submitted by Medicare Advantage Organizations and Prescription Drug Plans (MAO/PDPs). This work included examination of base period data, prescription drug events (PDEs) and medical claims, direct and indirect remuneration data (rebates), non-benefit expenses, and solvency.
Bob is a Certified Public Accountant (CPA) and a Certified Fraud Examiner (CFE). He is a member of the Maryland Association of Certified Public Accountants, the American Institute of Certified Public Accountants, the Association of Certified Fraud Examiners, and the Health Care Compliance Association.
Bob is a partner with Myers and Stauffer in our Kansas City office. He has more than 22 years of experience in Medicare and Medicaid auditing and consulting services for state Medicaid agencies and the Centers for Medicare & Medicaid Services (CMS). He has been involved in numerous reimbursement auditing and consulting engagements including cost reports, managed care, litigation, institutional rate setting, disproportionate share hospital (DSH), Medicaid upper payment limit (UPL) calculations, and children's hospital graduate medical education (GME) audits.
His experience includes approximately eight years with the Medicare fiscal intermediary, and more than a decade at Myers and Stauffer. Bob currently supervises litigation support, cost report desk reviews, focused audits, and field audits for state Medicaid agencies. His cost report experience includes hospitals, nursing facilities, outpatient therapy providers, community mental health clinics (CMHCs), rural health clinics (RHCs), home health agencies (HHAs), and other home and community-based services (HCBS). He has also assisted states with the development of Medicaid-specific cost reports.
Serving as the lead manager for several of the firm's DSH audit contracts, Bob has been involved with the firm's Medicaid DSH audits since the beginning of the first audits for 2005. He has established procedures and protocol for completing the DSH audits in accordance with federal regulations published in the December 19, 2008, Federal Register. Bob has conducted Medicaid DSH audit training sessions for several Medicaid programs to educate hospital providers on the federal DSH audit regulation.
Bob is a Certified Public Accountant (CPA) and a member of the American Institute of Certified Public Accountants and the Missouri Society of Certified Public Accountants.
Job Titles:
- Principal
- Principal With Myers
Bobby is a principal with Myers and Stauffer and a partner on the Pharmacy and Consulting engagement teams. He has more than 20 years of professional experience in the health care industry and specializes in public health law and policy. Bobby's work focuses on federal Medicaid waivers and state plan amendments; administrative rulemaking; delivery system reform; managed care; long term services and supports; and, in recent years, pharmaceutical reimbursement.
Since joining the firm, Bobby has worked with both state and federal government clients. He has assisted states in securing and implementing federal authority for initiatives related to delivery system reform; behavioral health and substance use disorders; home and community-based services; and managed care. He also supports several state Maximum Allowable Cost and Average Acquisition Cost programs for brand, multiple-source, and over-the-counter drugs, as well as the Centers for Medicare and Medicaid Services' (CMS) National Average Drug Acquisition Cost (NADAC) benchmark. He currently serves as a firm-wide resource for federal legislation and Medicaid flexibilities related to the COVID-19 pandemic.
Prior to joining Myers and Stauffer, Bobby served as a Senior Consultant with SVC, Inc., where he counseled clients on a variety of matters including Medicaid waivers; managed care; statutory and regulatory compliance; and public health program design and implementation. He also served as interim Chief Executive Officer at Managed Emergency Surge for Healthcare, Inc. (MESH), a nationally recognized health care coalition in Indianapolis, and spent eight years as a Strategic Planning Specialist at OSF Saint Francis Medical Center in Peoria, Illinois.
Bobby holds Juris Doctor and Master of Public Health degrees, both with concentrations in health law and policy. Bobby is an attorney licensed in the State of Indiana and is a member of the Indiana State Bar and the American Health Lawyers Associations. Bobby does not provide legal services to Myers and Stauffer clients. Any advice and/or communications between Bobby and Myers and Stauffer clients will not be afforded the protection typically afforded under the attorney-client privilege. He also currently holds an adjunct faculty position at the Richard M. Fairbanks School of Public Health and IUPUI, where he instructs graduate students on health care and public health emergency preparedness.
Job Titles:
- Member of the American Institute of Certified Public Accountants
- Partner on the Managed Care
Bruce is a partner on the Managed Care engagement team in the Austin, Texas office. With more than 17 years of experience, he serves as the leader of the Austin office's Managed Care team and focuses on auditing and analyzing managed care organizations. This includes conducting attestation and performance audits of financial and statistical information, risk assessments, and analyzing contract requirements. Bruce has extensive experience working with state governments performing monitoring activities of contracted vendors.
Bruce has led a variety of engagements for multiple states auditing Medicaid expenditures and consulting on associated program financial risks. These engagements include assessments of behavioral health organizations, managed care organizations and contracted Medicaid program vendors. Much of his work involves working with state governments to define agreed upon procedures to monitor specific program risks and examining specific expenditures reported to state government. Additionally, his responsibilities include work related to preforming medical loss ratio examinations.
Prior to joining Myers and Stauffer, Bruce held senior management positions with Grant Thornton, LLP, and the Texas State Auditor's Office. In these roles he performed audits of various state government entities and programs.
Bruce is a member of the American Institute of Certified Public Accountants and the Institute of Internal Auditors. Bruce is a veteran with 20 years of service in the United States Air Force.
Catherine is a leader on the firm's Consulting engagement team. She has more than 30 years of experience working with payers, providers, and managed care organizations to transform health care delivery and financing systems. She oversees the development of services to support state agencies in organizational design and change management, administration and oversight of contracts, managed care design and implementation, long-term supports and services, and payment transformation. Her state clients have included Medicaid, behavioral health, developmental disabilities, prisons, workers compensation, state employees, education, and child and family services agencies. She also provides support to counties and localities in the administration of health care-related contracts.Catherine has also supported state clients with litigation, testifying on issues related to payment adequacy, fee schedule design, managed care implementation, and the Olmstead Act. She has testified in state and federal courts and in numerous administrative hearings and arbitrations.
Prior to joining Myers and Stauffer, Catherine was a Managing Director at Navigant Consulting, where she was the practice leader for the Government Healthcare Solutions Practice. In that role, she led the delivery of services to state clients and the federal government. She also led engagements related to the implementation of the Affordable Care Act, and provided support to states on their State Innovation Model grants.
Catherine was a Vice President at Tucker Alan, Inc., where she was responsible for helping develop the government health care consulting practice. She was also a Practice Leader of the Government Social Policy and Systems practice at KPMG. Before she became a consultant, she held positions with employers focused on health care policy. They include the American Medical Association, the Blue Cross Blue Shield Association, and the federal Health Care Financing Administration (currently, the Centers for Medicare & Medicaid Services). These positions have provided her with an unparalleled understanding of the health care delivery and financing system in the United States. Catherine has authored numerous articles on health care financing issues and speaks frequently at national conferences.
Chris has more than 24 years of professional experience across a diverse range of human resources (HR) activities. He has successfully led HR teams for different organizations and provided day-to-day HR consultations to business leaders. His primary responsibilities include implementing national HR policies, procedures, and practices including compliance and recruiting functions as well as strategic planning. He has expertise in coaching and consultation to upper-level management and other internal clients. Chris leads a strong team of dedicated HR professionals across the firm who are committed to providing consultative services in HR, recruiting, and training and development to all Myers and Stauffer employees.
His certifications include Senior Professional Human Resources, SHRM Senior Certified Professional, Harrison Assessment System, Achieve Global and DDI Certified Trainer, and DiSC Certified Trainer.
Dan is a principal in our Indianapolis office, serving in a leadership capacity for the firm's Nursing Facility/MDS Verification engagement team, and it's upper payment limit compliance practice area. Through his more than 14 years of professional experience he has assisted state Medicaid agencies in navigating the challenging and complex healthcare landscape, particularly in the long term care and long term supports and services program areas.
He currently supervises engagements across multiple states, serving as a subject matter expert in acuity-based (case mix) nursing facility rate setting and rate system design, modernizing home and community based services rate systems, developing and supporting value-based purchasing programs, modifying state provider tax programs and evaluating other Medicaid financing arrangements, providing upper payment limit compliance consulting and reporting, and supervising the audit/review of provider cost reporting information and other oversight activities.
To support these state design and compliance efforts, Dan also assists in developing and implementing Medicaid cost reporting and cost survey instruments, drafting Medicaid state plan and other statutory/regulatory language, developing mechanisms to encourage and capture stakeholder feedback, providing testimony to state legislatures, and designing and delivering focused trainings to state and industry representatives.
Diane has more than 23 years of experience that includes health care-related audits, fraud investigations, and litigation support services. She has been working on disproportionate share hospitals (DSH) audits for more than 10 years, including assisting a state prepare for compliance prior to the issuance of the final DSH rule.
She has worked on DSH audits for many states including Connecticut, the District of Columbia, Massachusetts, New Hampshire, Oregon, Rhode Island, West Virginia, and South Carolina. She currently is the project manager for DSH audits in several of those states. Outside of disproportionate share hospitals, she has worked on state cost settlement engagements for hospitals, federally qualified health centers, rural health centers and institutions for mental disease as well as health care engagements with the Centers for Medicare & Medicaid Services.
She is a member of the American Institute of Certified Public Accountants and Maryland Association of Certified Public Accountants.
For more than 21 years, Emily has provided health care consulting and audit work, including eligibility reviews, performance evaluations, internal control reviews, disproportionate share hospital (DSH) audits and consulting, nursing facility audits, hospital audits, and claim and billing reviews for Alabama, Delaware, Illinois, Indiana, Kentucky, Michigan, Mississippi, North Dakota, Ohio, and South Carolina. She has extensive experience auditing and consulting for the Office of Inspector General of the U.S. Department of Health and Human Services, and the Centers for Medicare & Medicaid Services (CMS). She has served as an expert witness for the Ohio Department of Job and Family Services and the Mississippi Division of Medicaid, and has provided expert services to the southern district of the U.S. Department of Justice.
Emily brings vast experience in audits of eligibility. She is the Eligibility Review Manager as part of the national Eligibility Review Contractor (ERC) for CMS, responsible for completion of eligibility reviews for the Payment Error Rate Measurement (PERM). As the Eligibility Review Manager, she manages the eligible review processes that cover the planning, review, and reporting phases.
She had an integral part of the Eligibility Support Contractor (ESC) reviews, initiated by CMS, to obtain information to make changes in future PERM methodology. The revisions of the regulation and procedures were necessitated by eligibility processing changes that followed the Affordable Care Act (ACA). She managed the eligibility preview process for states participating in the ESC pilots, including the Medicaid agencies of Delaware, the District of Columbia, Kentucky, Massachusetts, and Michigan. Emily helped identify areas of change and assisted in the design of reporting tools and standard operating procedures for CMS in a consulting role.
Prior to the ERC and the ESC projects, Emily was the project leader for the eligibility reviews performed since 2008 on behalf of the Delaware Department of Health and Human Services, the Kentucky Cabinet for Health and Family Services, the Michigan Division of Health and Human Services, and the Mississippi Division of Medicaid. In addition to state-specific eligibility projects, she was also the project manager of three CMS-approved mini-PERM engagements for Michigan and CMS-mandated Eligibility Review Pilots for fiscal years 2014 through 2017 for Delaware, Kentucky, and Michigan.
Jared is a partner-in-charge of the firm's Rate Setting and Federal Compliance engagement team and is located in the Indianapolis office. For more than 21 years at Myers and Stauffer, he has provided rate setting, auditing, and consulting services to state Medicaid agencies and the Centers for Medicare & Medicaid Services (CMS).
Jared's experience includes quality and efficiency studies, reimbursement system development and maintenance, public health policy and economics, data analytics, utilization management, and fiscal management. Jared is experienced with a multitude of health care provider categories, and both fee-for-service and managed care delivery systems. He has conducted rebasing and recalibration studies, performed upper payment limit (UPL) tests, performed cost studies, analyzed policies, developed fiscal models, prepared state plan amendments (SPAs), and performed hundreds of audits.
Jared consults with state clients on opportunities to improve health care quality, efficiency of delivery, reimbursement, and health information technology (health IT). Jared has consulted with more than 20 Medicaid programs and CMS on issues such as delivery system reform and transformation; payment error rate measurement; fraud, waste, and abuse detection and specialized fraud investigations; contract compliance; risk mitigation and controls; program evaluation; stakeholder engagement, readiness reviews, and other audit initiatives. His work has involved virtually every health care provider category, managed health plan, health information exchanges, and fiscal agent contractor. He has designed studies to reduce errors and inefficiencies and/or opportunities for mis-payments that has resulted in savings of hundreds of millions of taxpayer funding.
Jared is a Certified Fraud Examiner (CFE) and a member of the Association of Certified Fraud Examiners, the Indiana Society of Certified Public Accountants, the American Institute of Certified Public Accountants, the National Health Care Anti-Fraud Association, and the American Society of Health Economists.
Education
B.A. with Distinction, Economics (Quantitative)
Indiana University
Jeff has more than 20 years of experience and has been the contract account manager along with co-managing the Des Moines office for the past 10 years which includes desk reviews and cost settlements for multiple provider types. He also manages consulting engagements such as upper payment limit (UPL) demonstrations, Medicaid managed care directed payments and provider tax assessment.
He is involved with implementing reimbursement methodologies and cost reports for new Iowa Medicaid services, fiscal impact analysis, and assists the client with identifying and implementing cost savings and Medicaid financing strategies. He provides on-going policy and procedure analysis for current Iowa Medicaid services which includes updating the State Plan Amendment and drafting administrative rules.
He also assists with development of Iowa Medicaid fee schedule reimbursement. This includes the annual updates from CMS for new procedures and pharmaceuticals as well as on-going updates deemed necessary by the Iowa Medicaid Policy staff. This requires an extensive knowledge of the American Medical Association (AMA) Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, Medicare Resource-Based Relative Value System (RBRVS).
Jeff supervises the hospital rebasing and recalibration for Medicaid reimbursement. This includes calculating inpatient and outpatient base rates, cost-to-charge-ratios, statewide averages, and disproportionate hospital share and graduate medical education payments for qualifying hospitals.
Jeff serves on the firm's Rate Setting/Federal Compliance engagement team. He is also a member of the Iowa Society of Certified Public Accountants.
Job Titles:
- Principal
- Principal With Myers
Jerry is a principal with Myers and Stauffer, a partner-in-charge of the Consulting engagement team, and the leader of the firm's Integrated Care Model (ICM) practice area. Through his more than 28 years of professional experience, Jerry brings a wide range of clinical, business, and health policy experience.
Since joining the firm, Jerry has focused on assisting our clients with delivery system and payment transformation initiatives. These initiatives include design, development, implementation, and assessment of innovative state models such as Delivery System Reform Incentive Payment (DSRIP) programs; Certified Community Behavioral Health Clinic (CCBHC) programs; managed care design, implementation, and monitoring; and other consulting activities.
Prior to joining Myers and Stauffer, Jerry served as Georgia's Medicaid Director for more than six years, where he was responsible for health care coverage for 1.9 million Georgians, and an annual benefits budget of nearly $10 billion. While with the state of Georgia, he also served as the Deputy Director of the Medical Assistance Policy Section, and as the Director of Pharmacy Services. He has had previous careers in the Medicaid Pharmacy Benefits Management (PBM) and pharmacy practice arenas.
Jerry holds a Doctor of Pharmacy degree and a Masters of Business Administration with a concentration in Health Services Management, and he maintains licensure in multiple states as a pharmacist.
Education
Doctor of Pharmacy
University of Arkansas Medical Sciences
Job Titles:
- Certified Public Accountant
- Member of the Firm 's Executive Committee
Jim serves as a member of the firm's executive committee. During his 30-year career with Myers and Stauffer, Jim has worked in all capacities on multiple auditing, rate setting, and consulting engagements, including project director, project manager, and quality assurance.
Jim has conducted audits and desk reviews of hundreds of health care providers including nursing facilities, hospitals, federally qualified health centers (FQHCs), home health agencies (HHAs) and Local Education Agencies (LEAs). Many of these audits or desk reviews also included auditing the home office entity or management company operating the facilities. Jim has also provided consulting and expert testimony on behalf of a state Medicaid agency that prevailed when it was challenged in federal court over their definitions of allowable cost, and the cost finding principles utilized.
In addition to the audit services, Jim has assisted several states in developing new reimbursement systems and policies including implementing case mix reimbursement systems for nursing facilities, revising DSH allocation methodologies, developing new reimbursement systems for intermediate care facilities for individuals with intellectual disabilities (ICF/IID) providers, and implementing FQHC prospective payment rates. Many of these projects have also included revising or developing cost reporting tools, including developing and providing training to the provider community on the new policies and forms.
Managing several of the firm's DSH audit contracts, including with the states of Georgia, Kansas Nebraska, New Mexico, and Texas, Jim has established the internal procedures and protocols for completing the DSH audits in accordance with the regulations established in the final rule published in the December 19, 2008, Federal Register. In addition, Jim has developed the learning material for comprehensive training seminars presented to hospital providers, as well as internal staff.
Jim has also been involved in the firm's quality control committee which develops and implements quality control policies across the firm. This includes overseeing the firm's involvement in the American Institute of Certified Public Accountant (AICPA) Peer Review program.
Jim is a Certified Public Accountant (CPA) and a member of AICPA, the Missouri and Kansas Society of Certified Public Accountants, and the Association of Government Accountants.
Joanna Garnett (Kansas City) has more than 15 years of experience. She provides consulting and public accounting services to state Medicaid agencies addressing health care reimbursement issues. She has led various Medicare/Medicaid accounting, auditing, and consulting engagements.
Joanna directs the daily activities for several of the firm's DSH examination and DSH payment contracts, Medicaid cost report audit contracts, and medical loss ratio (MLR) examination contracts. She has been involved in developing procedures and protocols for completing DSH audits and Medicaid cost report audits in accordance with federal and state regulations. Joanna worked closely with IT to develop the Myers and Stauffer web portal, and serves as one of the firm's internal IT business liaisons. She has also collected cost report data, claims data, and uninsured data for use in the DSH payment calculation as well as reading and interpreting payment specifications within state plans. Joanna also provides consulting and public accounting services to state Medicaid agencies addressing health care reimbursement issues. She has led various Medicare/Medicaid accounting, auditing, rate-setting, and consulting engagements.
She is a Certified Public Accountant and a member of the Missouri Society of Certified Public Accountants, the Kansas Society of Certified Public Accountants, and the American Institute of Certified Public Accountants.
Job Titles:
- Certified Public Accountant
Johanna is highly experienced in health care compliance auditing and consulting, including managing and performing audits of a variety of health care provider types. She has led a variety of compliance audit projects for state Medicaid programs, providing cost report and disproportionate share hospital (DSH) audit, consulting, and program integrity services to several state Medicaid agencies including Maryland, Nevada, New Jersey, Virginia, and Washington.
She is a member in the Richmond, Virginia office and serves on the leadership team of both the Cost Report Audit and DSH engagement team and the Benefits/Program Integrity (BPI) engagement team. She has performed and managed field audits and desk reviews of health care providers for state Medicaid agencies, including long-term care (LTC) facilities, hospitals, intermediate care facilities for individuals with intellectual disabilities (ICF/IID), federally qualified health centers (FQHCs), and other provider types. Her experience also includes the performance and oversight of hospital compliance audits, the design and development of audit programs for certified public expenditures (CPE) of local government agencies, performance and oversight of DSH audits, audits of transportation services, electronic health records (EHR) audits, charity care audits, and other consulting and program integrity services.
Johanna is a Certified Public Accountant (CPA) and a member of the American Institute of Certified Public Accountants and the Virginia Society of Public Accountants.
Job Titles:
- Certified Public Accountant
With more than 25 years of experience, John serves as project director for many of the firm's auditing and consulting engagements for state Medicaid agencies.
He has been involved with the Commonwealth of Pennsylvania from the inception of the contract in 1992. He was previously responsible for the design, development, and implementation of computerized case mix rate setting systems. He maintained direct contact with state agency staff to coordinate the provider, cost, and capital information necessary to establish case mix rates for providers, reviewed all outgoing information to providers for accuracy, and attended state agency and provider advocacy meetings on a regular basis to share information. He determined the provider information necessary to operate a case mix system and assisted with the design and implementation of a method to display and update the information as necessary. He supervised the help desk supporting provider queries concerning minimum data set (MDS) submission and CML reporting..
In Maryland, John is also responsible for coordinating the resources to provide nursing facility, hospital, residential treatment center (RTC), intermediate care facility (ICF)-alcoholic and state facility auditing and rate setting services to ensure medical assistance reimbursements are in compliance with state and federal laws and regulations. He assisted the Maryland Department of Health in their development of a case mix reimbursement system for nursing facilities.
Managing an engagement with the Maryland Health Care Commission, John led the team in providing MDS data and long-term care (LTC) planning consulting services. This included providing data analysis and consulting to support the Commission's planning and policy development for LTC services.
Mr. Dresslar is a Certified Public Accountant (CPA) and is a member of the American Institute of Certified Public Accountants, the Maryland Association of Certified Public Accountants, and the Pennsylvania Institute of Certified Public Accountants.
Since starting with the firm in 1992, John has performed Medicare and Medicaid audit, desk review, and rate calculation services. As a member of Myers and Stauffer, he provides high-level strategic input to ensure the successful completion of each project.
He is currently overseeing Medicaid disproportionate share hospital (DSH) audits for numerous states throughout the country including Connecticut, New Hampshire, Oregon, Rhode Island, and South Carolina. For the states of Georgia, New Hampshire, New Jersey, South Carolina, and Vermont, he manages and reviews field audits and desk reviews of Medicaid cost reports for hospitals, federally qualified health centers (FQHCs), and rural health clinics (RHCs). He also manages tentative settlement, final settlement, and interim rate calculations, as well as overseeing the development of standard work papers and procedures, compliance with applicable attestation standards, and workload objectives.
John is a key participant in the health care litigation support practice area providing health care fraud investigation services for the U.S. Department of Justice (DOJ). In addition, he has provided litigation support services and expert witness testimony for the firm's state Medicaid clients' cost report appeals.
John is a Certified Public Accountant (CPA) licensed in the states of Maryland, New Hampshire, South Carolina, and Vermont. He is also a Certified Healthcare Financial Professional (CHFP), and a member of the Maryland Association of Certified Public Accountants, the American Institute of Certified Public Accountants, the Healthcare Financial Management Association, and the American Health Lawyers Association.
Job Titles:
- Certified Public Accountant
- Partner
Judy is a partner with Myers and Stauffer in our Kansas City office, and serves as the Managed Care engagement team's quality control leader. She has more than 28 years of experience providing auditing, consulting, and advisory services to Medicaid agencies related to hospitals, nursing facilities, disproportionate share hospital (DSH) payments, and Medicaid managed care programs.
Judy has led a variety of Medicaid auditing, rate setting, and managed care consulting engagements for Myers and Stauffer. She has been involved with the Medicaid DSH audits, payment calculations, and consulting services with Myers and Stauffer from the beginning of the first audits in 2005, as well as overseeing hospital Medicaid cost report audits. Much of her recent work involves the testing of Medicaid managed care health plan claims processing systems for state agencies to ensure proper payment and contract compliance. Additionally, her responsibilities include work related to Medicaid managed care encounter data completeness and external quality reviews.
Prior to joining Myers and Stauffer in 2009, Judy worked with a national certified public accounting firm in the health care audit and reimbursement department, performing financial statement audits and preparing Medicare and Medicaid hospital, nursing home, home health agency, and rural health clinic cost reports. She assisted clients in researching, applying, and interpreting the Centers for Medicare & Medicaid Services' (CMS) Publication 15-1, allowing for the accurate completion of cost reports and fair settlement of appeals. Additionally, her management of the finance department, work in the internal audit department, and in cost accounting for a large hospital system, a community hospital, and a physician practice provide a unique understanding of the health care industry from all perspectives.
Judy is a Certified Public Accountant (CPA), a member of the American Institute of Certified Public Accountants, and the Healthcare Financial Management Association.
Kathy has more than 28 years of experience. She is experienced in health care policy and reimbursement analysis, managed care organization contract compliance review, and encounter data validation. She performs various analyses of correct coding on health care claims and analyses of health care policy and reimbursement for state Medicaid managed care programs. She also conducts analyses of Medicaid and state CHIP encounter claims to identify overpayments and performs on-site activities at managed care organizations. Kathy implements and manages external quality review protocols related to the validation of encounter data using medical record reviews, trace analyses, and other tools. She generates reports and presentations, provides project management and is skilled in the development of analytical tools.
Kathy is a Certified Fraud Examiner, a Certified Coding Associate, and Certified Outpatient Coder. She also is certified in Healthcare Compliance and is a Master of Planning. She is a member of American Academy of Professional Coders, American Health Information Management Association, Association of Certified Fraud Examiners, and Health Care Compliance Association.
Job Titles:
- Certified Public Accountant
- Partner
Keith is the partner-in-charge of the firm's Raleigh, North Carolina office and he is a co-partner in charge of the managed care engagement team. He has nearly two decades of health care audit and consulting experience, specializing in compliance auditing for health care programs, with an emphasis on Medicare and Medicaid regulation compliance and reimbursement issues.
From 2005 to 2009, and from 2013 to the present, Keith managed our contract with the North Carolina Department of Health and Human Services (DHHS). In this capacity, he has provided management oversight annually, for more than 50 long-term care (LTC) facility audits, 80 hospital audits, and provided technical assistance to DHHS related to provider audit protocols, provider appeals, and mediation hearings. Prior to working with our DHHS client, he spent five years performing desk reviews and field audits of Maryland Medicaid cost reports.
Since 2009, Keith has managed audits overseeing the Medicare Part C and D programs for the Centers for Medicare & Medicaid Services (CMS). His Part C and D experience includes managing financial examinations of Medicare Advantage Organizations and Prescription Drug Plans (MAO/PDPs), reviews under the Medicare Drug Integrity Contractor (MEDIC) program, and compliance and performance audits of MAO/PDPs. In addition, he has conducted presentations on the Part C and D payment processes for CMS and law enforcement agencies.
Since 2017, Keith has managed a consulting engagement with the Illinois Department of Health and Family Services (DHFS) which involves validating the outstanding provider liabilities on the books of the 12 managed care organizations (MCOs) administering benefits for the Department.
Keith is a Certified Public Accountant (CPA) and a Certified Fraud Examiner (CFE). He is a member of the American Institute of Certified Public Accountants, the Association of Certified Fraud Examiners, and the North Carolina Society of Certified Public Accountants.
Job Titles:
- Principal
- Principal of Myers
Kevin is a principal of Myers and Stauffer, working from the Kansas City office.
His 19 years of experience with state Medicaid agencies and the Centers for Medicare & Medicaid Services (CMS) have included proficiencies in auditing and consulting engagements related to cost reports, Medicare and Medicaid disproportionate share hospital (DSH), Medicaid upper payment limit (UPL) calculations, worksheet S-10 reviews, and healthcare provider taxes.
Prior to joining Myers and Stauffer in 2006, Kevin worked for a Medicare fiscal intermediary and a national certified public accounting firm auditing and preparing Medicare and Medicaid cost reports. Kevin has led and assisted with Medicaid DSH audits, payment calculations, and consulting services (including UPL demonstrations, hospital directed payments, and provider tax calculations). He currently manages the development of a nationwide risk assessment related to Medicare cost reports, worksheet S-10 reviews, external quality reviews, and coordination of numerous CMS initiatives.
Kevin serves on the leadership team of the Cost Report Attest and DSH Audit engagement team and is a member of the Healthcare Financial Management Association.
Krista has more than 18 years of experience in the government health care arena. She is responsible for the supervision, management of daily workloads, and mentoring and training of staff and senior accountants, particularly for the Idaho nursing facility project. She works on consulting projects for the state of Idaho, which included implementing a quality-based supplemental payment system and developing a modified nursing facility rate system. She also consulted with Alaska on implementing a case-mix reimbursement system for their nursing facilities.
More recently, Krista gained experience in designing cost surveys, compiling cost data, and calculating rates for home and community-based service in multiple states. She has additional project experience that includes setting rates for federally qualified health center providers, hospital and home health agency cost settlements, and various disproportionate share hospitals. She reviews interim and final hospital cost settlements for Idaho hospitals, out-of-state hospitals, and home health agencies, and she has developed cost surveys and compiled results for various waiver program services.
She is a member of the American Institute of Certified Public Accountants and Idaho Society of Certified Public Accountants.
Job Titles:
- Principal
- Principal With Myers
Mark is a principal with Myers and Stauffer and a partner-in-charge of the firm's Cost Report Attest and DSH Audit engagement team. He leads projects that involve developing audit programs and completing examinations of various types of health care providers and also works with various payment systems and benefit integrity issues.
Mark has more than 25 years of extensive experience working on health care and government compliance audit engagements. Prior to being at Myers and Stauffer, he was the Director for the Division of Provider Audit Operations, Office of Financial Management for the Centers for Medicare & Medicaid Services (CMS) in Baltimore, where he managed the national Medicare cost report audit and reimbursement process. Some of his accomplishments include overseeing the development and updating of Medicare cost report audit and reimbursement protocols used by contractors nationwide, managing numerous contractor activities, managing the cost report appeals process, and quality review processes. He also worked in conjunction with other CMS components to develop, review, and implement policy updates.
Mark worked closely with the Office of the Inspector General (OIG), Federal Bureau of Investigation (FBI), and Department of Justice (DOJ) regarding instances of fraud and to provide litigation support. He led the development and implementation of the CMS Electronic Health Record (EHR) Meaningful Use (MU) Audit Program used by Medicare, which included the development of the overall audit strategy, as well as the audit methodologies. Mark has a background of working closely with state and federal clients to develop audit strategies and protocols, building risk assessments, and providing various benefit and program integrity functions.
Mark is a Certified Fraud Examiner (CFE) and is a member of the Association of Certified Fraud Examiners.
Marty is the partner-in-charge of our Tallahassee office. With more than 16 years of health care auditing experience, he is responsible for providing consulting and public accounting services to state Medicaid agencies addressing health care reimbursement issues. Throughout his tenure at Myers and Stauffer, he has managed various Medicaid engagements including cost report audits, disproportionate share hospital (DSH) examinations, uncompensated care (UC) reconciliations, electronic health records (EHR) post-payment agreed-upon procedures (AUPs), institutional rate setting, and consulting.
In 2007, Marty relocated to Honolulu to establish and manage our Hawaii office and audit contract. He set up the office space, recruited additional staff, and established policies and procedures to perform the required audit and rate setting engagements. He was instrumental in consulting with the Hawaii Department of Human Services in the revision of federally qualified health center and rural health clinic administrative rules, as well as serving as the lead manager for Medicaid cost report AUPs reviews for Hawaii hospitals, nursing facilities, and intermediate care facilities for individuals with intellectual disabilities (ICF/IID).
He also leads various Medicaid accounting, auditing, rate setting, and consulting engagements, including contracts with the Alaska Department of Health and Social Services, Kansas Department of Health and Environment, the Missouri Department of Social Services, the Nebraska Department of Health and Human Services, and the Texas Health and Human Services Commission. For these engagements, Marty is responsible for managing the supervisors and staff that run the daily activities of various Medicaid contracts. His duties include setting up the initial project requirements; communicating with clients; providing subject matter expertise; ensuring adequate staffing, training, and supervisory reviews; and ensuring complete client satisfaction with project deliverables.
Marty began his career with Myers and Stauffer performing desk reviews and audits on New Mexico hospitals, nursing facilities, ICF/IID, and home health agencies to include multiple-facility health care chain home office desk reviews and audits. He has been responsible for the calculation of New Mexico direct graduate medical education eligibility and quarterly disbursements.
He holds a B.S. in Business Administration and an M.Acc., Master of Accountancy from Kansas State University. He is a Certified Public Accountant (CPA) in the states of Florida, Hawaii, and Kansas and is a member of the American Institute of Certified Public Accountants and the Florida Institute of Certified Public Accountants.
Dr. Frenzen has over 14 years of experience in health care analytics, strategy, and policy in the public health sector. She currently serves as a Principal at Myers and Stauffer. She has extensive experience in state-level rate development initiatives, programmatic- and policy-related HCBS waiver work, and complex project management. Dr. Frenzen's area of specialization lies in program structuring and resource allocation for marginalized patient populations, especially the intellectually and developmentally disabled.
Prior to her role with Myers and Stauffer, Dr. Frenzen served as a Managing Director at CBIZ Optumas where she oversaw projects for state Medicaid programs, private insurers and health plans, and county-level public health programs. Dr. Frenzen's expertise in public health and Medicaid financing has positioned her to support clients in making difficult policy and programmatic decisions around rate setting processes and Total Cost of Care (TCOC) analyses. Dr. Frenzen uses her state-level experience to support clients in the pursuit of improving quality and patient outcomes.
Dr. Frenzen's career has included development of risk adjusted rates in New York, Nebraska, Alabama, North Dakota, Maryland, and Colorado. Her work in these states has included overseeing calculations of MCO capitation rates under 1115 waivers, carve-out rates, behavioral health rates, TCOC for accountable care organizations (ACOs), managing of budget neutrality parameters, the resetting of risk adjustment factors, trend analyses, and forecasting. These projects have required the use of multiple data sources, including detailed claims and eligibility data, incomplete encounter data, financial statements, historical cost data, and other publicly available data. Additionally, Dr. Frenzen has extensive experience in stakeholder engagement and highly values the role of qualitative data in health care decision making. Dr. Frenzen's academic background has positioned her well to utilize and synthesize multiple data sources to improve processes and outcomes based on the needs of her clients.
Dr. Frenzen earned her Ph.D. at the University of Massachusetts at Amherst, an MBA from the University of Vermont, and a Master of Science in Health Economics, Policy, and Management from the London School of Economics.
Job Titles:
- Certified Public Accountant
- Partner
Mike is the partner in charge of the firm's Atlanta, Georgia office and serves as an engagement team partner in charge for both our managed care, audit, and consulting practice and the benefit/program integrity team. He has extensive experience working with state Medicaid agencies, conducting examinations and performance audits testing for compliance on Medicaid managed care health plans; conducting various program integrity engagements, including payment audits; and assisting with data quality and data analysis. Mike also worked with numerous states addressing Health Information Technology for Economic and Clinical Health (HITECH) compliance issues including conducting electronic health record (EHR) post-payment reviews.
While Mike has worked on a variety of engagements throughout his two-decade career, much of his recent work has involved supporting multiple states on the implementation and oversight of the Medicaid managed care program and complying with the managed care rule. Mike has provided oversight on multiple Medical Loss Ratio (MLR) examinations and was recently a CMS invited panelist at a conference discussing MLR examinations. Another accomplishment includes helping states comply with the new managed care rule by developing a strategy to reconcile and validate managed care organization (MCO) encounter claims. With implementation of this strategy, several states have seen their MCOs raise their completion rates and clean up erroneous encounters in the process. As part of his managed care support, Mike has assisted states by conducting performance audits of the MCOs and by providing best practices and suggested contract language for states to utilize in their managed care program oversight.
Mike has worked with more than a dozen states to develop audit strategies for program oversight and payment integrity-related to the EHR incentive payment program. As part of the strategy, fee-for-service (FFS) and encounter data was utilized to develop risk assessments. This strategy was recognized by the Centers for Medicare & Medicaid Services (CMS) as a best practice, and he has been an invited speaker on this topic at the national HITECH conference. Prior to joining Myers and Stauffer in 2008, Mike managed the claims analysis unit of the Healthcare Audits Division for the Georgia Department of Audits and Accounts (GDOAA). While at GDOAA, he also supervised and audited nursing home and home health cost reports and designed a rate setting program for skilled nursing facility (SNF) reimbursement. Mike has performed on-site audits of state agencies and county school boards throughout the state of Georgia. He has also served as an expert witness for the state of Georgia and the U.S. Department of Justice (DOJ) in Medicaid fraud trials.
Mike is a Certified Public Accountant (CPA) and a Certified Fraud Examiner (CFE). He is a member of the American Institute of Certified Public Accountants, the Association of Certified Fraud Examiners, the Georgia Society of Certified Public Accountants, and the National Healthcare Anti-Fraud Association.
Missy has more than two decades of experience with health care-related consulting audits, including more than 10 years of work with the U.S. Department of Justice (DOJ). She is currently involved with numerous health care fraud investigations and litigation support service engagements. She has extensive trial testimony experience including testifying in trials, sentencing hearings, and providing non-testimony assistance for trial teams.
She is responsible for assisting the DOJ and the Federal Bureau of Investigation (FBI) with indictment preparation, calculation of damages, identification of issues, asset tracing, money laundering schemes, forensic analysis of bank records, claims trending, claims analysis, calculating the lowest intermediary balance of accounts, length of stay analysis, cycling of patients, time studies, seizure warrants, trial charts, and meeting with relator and hospital on qui tam investigations related to false claims submitted to the government. She has testified in more than 20 federal trials and sentencing hearings related to home health agencies (HHAs), physicians, hospitals, community mental health centers (CMHCs), human immunodeficiency virus (HIV) clinics, and recruiters. She currently oversees the FBI mega contract work which provides any FBI field office assistance with their health care fraud case work. Missy has worked in several of the DOJ strike force cities, and as such, has been a part of joint government agency teams investigating health care fraud.
In addition to her litigation work, she has performed audits on behalf of the Centers for Medicare & Medicaid Services (CMS) related to chief financial officer (CFO) audits, regional office audits, and agreed-upon procedure (AUP) projects. She also has experience with disproportionate share hospital (DSH) state procedures, Medicare cost reports, Medicare audits, and state of Maryland on-site audit work. She is proficient in Medicare, Medicaid, Tricare, and private insurance claims related to all provider types.
Missy is a Certified Fraud Examiner (CFE) and a member of the Association of Certified Fraud Examiners.
Ryan is a partner-in-charge of the firm's Benefit/Program Integrity (BPI) engagement team. In addition to co-leading the BPI practice area, he is responsible for the management of operations in the Austin, Texas office, as well as the management of health care engagements across numerous state and federal agencies.
In his two-decade career, he has overseen various engagements involving provider fraud, waste, and abuse detection (FWAD); managed care/health plan compliance; encounter claims analyses and auditing; Management Enterprise System (MES) assurance; payment error rate measurement (PERM) and eligibility determination evaluations; electronic health record (EHR) incentive payment analyses and audits; litigation support; and delivery system reform consulting and evaluations. His current responsibilities include providing high-level strategic input to state and federal agency clients, as well as general management and oversight of various engagements. His engagement responsibilities and experience include conducting on-site audits; evaluating provider and health plan compliance with contractual and regulatory requirements; overseeing post-payment review of service utilization claims; integrity monitoring for reimbursement systems; identification of aberrant billing and/or reimbursement practices; creation and manipulation of complex data sets; analysis of expenditure trends; development of reimbursement models; and preparation of written and oral reports and presentations.
He has been responsible for the identification of hundreds of millions of dollars in provider, health plan, and system-generated fraud, waste, and abuse throughout his career. He is experienced with the format, content, and uses for health care claims information, working extensively with Centers for Medicare & Medicaid Services (CMS) 1500, Uniform Bill (UB)-04, dental, pharmacy, reference data, shadow encounter claims, and the electronic claims formats (e.g., 837s, National Council for Prescription Drug Programs [NCPDPs], etc.) received by and from government payers and managed care organizations (MCOs).
Ryan is a Certified Fraud Examiner (CFE) and a member of the Association of Certified Fraud Examiners, the Texas Society of Certified Public Accountants, and the American Institute of Certified Public Accountants.
Job Titles:
- Certified Public Accountant
- Partner
Scott is a partner in our Atlanta office and has more than 25 years of health care program integrity experience performing and managing examinations, reviews, agreed-upon procedures (AUP) engagements, and performance audits conducted in accordance with Generally Accepted Government Accounting Standards and American Institute of Certified Public Accountants (AICPA) guidelines. Scott has also testified as an expert witness for state government agencies. Scott has managed many projects for Myers and Stauffer, including multiple electronic health record pre- and post-payment review engagements, Women, Infants, and Children vendor analysis and verification reviews, and nursing facility cost report audits.
Scott is a Certified Public Accountant (CPA), a Certified Fraud Examiner (CFE), a Project Management Professional (PMP), and a Chartered Global Management Accountant (CGMA). He is a member of the Georgia Society of Certified Public Accountants, AICPA, and the Association of Certified Fraud Examiners.
Job Titles:
- Certified Public Accountant
- Partner
Tammy is the partner in charge of the firm's Boise office. She is also a co-partner in charge of the cost report attest and disproportionate share hospital (DSH) audit engagement team. She has more than two decades of professional experience in the areas of health care reimbursement, consulting, auditing, and rate setting. She has served as the office manager of the firm's Boise, Idaho office since 2006, and is the lead project director on several of our state programs related to long-term care (LTC) audit, disproportionate share hospital (DSH) audit, rate setting, electronic health record (EHR) audit, and consulting contracts. As part of her role, she manages the day-to-day operations, serves as the client contact, establishes audit practices and procedures, and performs general consulting functions such as provider tax calculations, DSH payment calculations, and upper payment limit (UPL) calculations for her clients.
Since 1994, Tammy has conducted and assisted with Medicaid field audits and desk reviews of LTC facilities, hospital-based facilities, federally qualified health centers (FQHCs), intermediate care facilities for individuals with intellectual disabilities (ICF/IID), EHR providers, and disproportionate share hospitals. She is responsible for drafting the audit and consulting work programs, and managing the work related to our audit and rate setting projects in our Boise office.
Additionally, she is responsible for conducting Medicaid DSH audit training sessions for the Alaska, California, Idaho, Minnesota, Montana, North Dakota, and Wyoming Medicaid programs. She serves as the project director of the firm's EHR contracts with Hawaii, Idaho, and Wyoming. She participated in Years 3 and 4 of the Payment Error Rate Measurement (PERM) Pilot program for the state of Idaho and has provided consulting services for revisions to reimbursement methodologies to determine fiscal impact to both providers and the states of Idaho and Wyoming. She modeled the potential conversion to a case mix system for the state of Wyoming, and participated in the evaluation and review of the conversion from minimum data set (MDS) 2.0 to 3.0 for the states of Idaho and Montana.
Lastly, she has assisted the state of Idaho with conducting cost surveys for waiver programs in the areas of residential habilitation, children's developmental disabilities, assisted living facilities, and personal care agencies. She developed cost survey templates to send to providers, conducted provider training webinars on the completion of the surveys, and compiled the data into reports.
Tammy is a Certified Public Accountant (CPA) and a member of the American Institute of Certified Public Accountants and the Idaho Society of Certified Public Accountants.
Tara is the partner-in-charge of the firm's Frankfort office and a partner-in-charge of the firm's Nursing Facility/MDS Verification engagement team. With more than 18 years of experience, Tara works with Kentucky Medicaid and manages the day-to-day activities of the Frankfort office, which includes overseeing all aspects of the firm's rate setting contract with the Kentucky Department for Medicaid Services (DMS).
The activities managed include establishing rates and cost settlements, developing and performing agreed upon procedures, monitoring litigation and resolutions, Medicaid financing, and consulting with the client. She oversees attest and/or rate-setting work for rural health centers and federally qualified health centers (RHC/FQHC), community mental health centers (CMHC), intermediate care facilities for individuals with intellectual disabilities, skilled nursing facilities, Veteran Affair nursing facilities, and hospital inpatient and outpatient services. She assists with consulting services including upper payment limit (UPL) demonstrations, hospital directed payments provider tax calculations, certified public expenditures, state plan amendment (SPA) and regulation writing, and fiscal impact analysis. She also oversees the disproportionate share hospital (DSH) exam (since the implementation in 2009) and payment projects for Kentucky. Her experience also includes gaining expertise in reimbursement topics such as PDPM and impacts of COVID-19.
Tara serves on the firm's nursing facility rate setting engagement team and is a certified public accountant and a member of the American Institute of Certified Public Accountants, the Kentucky CPA Society, and the Healthcare Financial Management Association.