Develops and maintains policies, regulations, and instructions that define the scope of benefits under prospective payment systems for hospital and other healthcare services.
Evaluates and establishes payment amounts for inpatient, outpatient, long-term care, ambulatory surgical center, physician, rural health clinic, federally qualified health center, blood, and opioid treatment services.
Oversees the activities of the Advisory Panel on Hospital Outpatient Payment and the Advisory Panel on Clinical Diagnostic Laboratory tests, including hosting the Annual Lab Meeting.
Maintains continuing liaison with provider groups, industry associations, patient organizations, medical associations, and other stakeholders that relate to Medicare benefits.
Provides interpretations of established policies and technical assistance to other agency components and regional offices, State agencies, Medicare administrative contractors, congressional staff, and other departmental offices.
Develops, evaluates, and maintains national Medicare scope of benefits and payment methodologies for payment systems under HAPG's purview.
Director, Hospital and Ambulatory Policy Group (HAPG) • Gwynn Oak, MD, United States
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