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.
Education
B.B.A., Accounting
University of Nebraska-Lincoln
Specialties
- Fiscal impact modeling and reimbursement rate analysis.
- Rate setting and reimbursement development.
- Medicaid financing and UPLs.
- Policy and procedure analysis for Medicaid services.
“One of the first things I was told about Medicaid is that if you have seen one Medicaid program, then you have seen one Medicaid program. This statement is very true as each state Medicaid program varies in services offered and reimbursement methods and strategy. Myers and Stauffer is able to navigate through these differences and offer solutions to our clients to allow for them to sustain current services but also expand the array of services to Medicaid recipients. Myers and Stauffer goes above and beyond to provide the best service to our clients.”
— Jeff Marston
