General CounselCharlie brings to Gorman Health Group clients in-depth Medicare operational and policy experience. Since joining GHG, Charlie has consulted on general Medicare policy issues in the industry. In addition, he writes and negotiates proposals and contracts between GHG and its various clients.
Prior to joining GHG, Charlie worked for the Centers for Medicare & Medicaid Services (CMS) in the Chicago regional office. While there he gained an extensive knowledge of the Medicare program by working in the Medicare Advantage Branch, Provider Services Branch and serving as the regional office Congressional Liaison.
As a Managed Care Operations Specialist, in the Medicare Advantage Branch, Charlie was responsible for interpreting Medicare laws, regulations, and policies to assess Medicare Advantage plans’ compliance with CMS regulations and guidelines.
Charlie also reviewed initial applications and service area expansions for MA plans. In addition, he provided technical assistance to individual MA plans on Enrollment, Marketing, Claims, and Appeals and Grievances policies under the MA program.
As a Health Insurance Specialist, in the Provider Services Branch, Charlie was the regional office lead on several Medicare Parts A, B and D policy areas. In particular: the payment and coverage policy for Home Health and Hospice; Part A and B Appeals; HIPAA; and Retire Drug Subsidy. In addition, he educated and provided technical assistance to Medicare providers, contractors and the general public on these policy areas.
Finally, as the Congressional Liaison for the regional office, Charlie served as the primary point of contact for Congressional office staff on CMS laws, policies and procedures. In this position he provided authoritative guidance to Congressional office staff on Medicare and Medicaid programs. In addition, he provided training and education to Congressional office staff on the Medicare program.
Charlie earned his J.D. from Case Western Reserve University School of Law in Cleveland, OH and his Masters of Public Health, concentrating in Health Policy and Administration, from the University of Illinois School of Public Health in Chicago.