Dr. James Georgoulakis BA, JD, MBA, Ph.D. Profile

I. Experience with APCs – CMS

• 1986 – 1993 Assigned by the Department of Defense (DOD) to be DOD representative to Center for Medicare and Medicaid Services
  (CMS) formerly Health Care Financing Administration’s (HCFA) in the development of what is now the APCs.
• Director of Joint DOD and HCFA evaluation of 3M APGs,
• Consultant to CMS on APCs
• 1995 – Present Member of American Medical Association (AMA) and CMS Resource Value Update Committee (RUC) responsible
  for advising CMS on Medicare Reimbursement Rates and Policies

II. Experience with APCs Hospitals

• Performed APC assessments for over 200 hospitals including some of the U.S. News and World Report’s most prestigious hospitals:
  • Rush-Presbyterian
  • St. Lukes Medical Center
  • Chicago
  • Illinois
  • The Cleveland Clinic Hospital
  • Cleveland Ohio
  • Lakeland Regional Medical Center.
• Responsible for conducting APC assessments for a number of the country’s leading consulting firms including Navigant Consulting.

III. Experience with Commercial Payors and APCs

• Anthem Blue Cross Blue Shield
• Developed modeling tools to monitor hospital payments under the APC system compared to private pay
• Keynote Speaker at the Private Payors Leveraging APC Modeling for Commercial Populations Conference
  Chicago, Illinois September 2005.

IV. Integration with OIG - Compliance

• More than 15 articles on the APCs and Compliance Issues
• Most recent article December 5, 2005 Report on Medicare Compliance “Compliance Officers Role to Grow as APC
  Changes and Multiples in 2006.
• Feature Speaker Health Care Compliance Officer’s Association Annual Compliance Institute 2003 and 2005 New Orleans, Louisiana.

V. Publications

• Four books including A Guide to the APCs: Implementing and Monitoring an Effective Hospital Program, published by Atlantic Information Services
• The Hospital Emergency Department: A Guide to Operational Excellence, published by the American Hospital Association.
• Annual Contributor to Medicare RBRVS: The Physicians’ Guide, published annually by the American Medical Association

VI. Monographs

• Understanding APCs in Oncology –published by the Oncology Roundtable, Washington, DC
• APCs 2002 Beyond Implementation Assessment Survey: A Guide for Improving Revenues – Atlantic Information Services and Medicare Compliance, Washington, D.C.

VII. Presentations (2005)

• American College Health Care Executives 2003, Chicago, Illinois (tape of presentation available from ACHE)
• Healthcare Financial Management Association, Albuquerque, New Mexico
• Michigan Hospital Association, East Lansing, Michigan
• Health Care Compliance Association’s Annual Compliance Institute New Orleans, Louisiana
• American Psychological Association, Washington, D.C.
• Commercial Payors Conference, Chicago Illinois

VIII. International Consulting

• Selected by the Canadian Government as Chief Consultant to design an ambulatory classification and payment system.