The national law firm of Epstein Becker Green is expanding its efforts to help clients navigate increasingly complex Medicare, Medicaid, and related public health programs affected by the Affordable Care Act (ACA) with the addition of three former executives from the Centers for Medicare and Medicaid Services (CMS), all of whom most recently worked at Dentons law firm in Washington, D.C.
Larry Kocot, former Senior Advisor to the Administrator of CMS and a leader in the implementation of the Medicare Prescription Drug Benefit (Part D) at CMS, joins as a Member of the Firm in the Health Care and Life Sciences practice and as an Advisor with EBG Advisors in the firm’s Washington, D.C., office. He is currently a visiting fellow in the Economic Studies Program at the Brookings Institution.
Mark Hamelburg, former Director of the Medicare Part C and Part D Analysis Group at CMS, joins as a Member of the Firm in the Health Care and Life Sciences practice and as an Advisor with EBG Advisors in the firm’s Washington, D.C., office.
Thomas E. Hutchinson, former Director of the Medicare Plan Payment Group at CMS, joins as a Strategic Advisor with EBG Advisors in its new Baltimore office, which is located at 7000 Security Boulevard.
Mark Lutes, Chair-Elect of Epstein Becker Green’s Board of Directors, noted that clients are increasingly looking to the firm for assistance in relating to CMS’ traditional payment programs as well as its accountable care and other payment reform initiatives. “Having Larry, Mark, and Tom on board, all of whom have deep-rooted experience and knowledge of these programs, significantly strengthens and enhances our ability to provide clients with a deep understanding of CMS payment systems and the numerous payment, reimbursement, and delivery reform changes contained in the ACA.”
Kocot added, “Epstein Becker Green has earned a national reputation for innovative thought leadership in the health care and life sciences sectors. We are excited to join such a progressive and forward-looking team that shares our vision for providing creative, comprehensive, and practical legal and policy solutions to meet client’s business needs.”
While at CMS, Kocot was involved in a wide range of health care policy and operations issues related to Medicare and Medicaid. Notably, he was a key member of the management and operations team responsible for the launch and operation of
Medicare Prescription Drug Benefit (Part D). Kocot led the development of pharmacy and long-term care pharmacy policy under the Part D program; guided CMS efforts to design and develop new systems functionality for providing beneficiary information to providers in real time at the point of sale; designed and launched CMS initiatives on pharmacy quality and pharmacy quality alliances; and developed outreach, communications, and partnership programs with the pharmacy and pharmaceutical communities. Kocot represents a broad array of clients in matters ranging from government investigations and qui tam actions to corporate strategy and action plans for implementation and compliance with health care laws and regulations.
Hamelburg focuses on a broad range of matters relating to the Medicare Prescription Drug and Medicare Advantage programs and on evolving areas of payment and health delivery reform in which CMS plays a key role, such as ACOs and health insurance exchanges. Drawing on senior roles in which he served at CMS, he offers significant experience on a wide range of matters, including payment policies, compliance plan obligations, CMS reporting requirements, enrollment and disenrollment rules, coordination of benefits, employer waiver plans, marketing guidelines, formulary requirements, the manufacturer coverage gap discount program, the Retiree Drug Subsidy Program, and private health insurance exchange issues.
At CMS, Hutchinson was responsible for all aspects of annual Medicare payments to Part C (Medicare Advantage) and Part D (drug) plans, totaling approximately $160 billion. This included all payment policy, systems development and implementation of the policies, validations of payments, and ensuring auditing compliance of these payments. The Part D risk adjustment model and the new (for 2012) Part C risk adjustment model were both developed under his leadership. Hutchinson was the driving force behind the design and implementation of the Medicare Risk Adjustment Data Validation (RADV) audits. He counsels clients on a wide range of payment policy and CMS-related operations issues.
Kocot, Hamelburg, and Hutchinson join another Epstein Becker Green member who served in a leadership position in the health care industry—Leslie Norwalk, who was Acting CMS Administrator during President George W. Bush’s administration.
