Joe Gamis, CFE, MBA

Joe has been with Myers and Stauffer for over a decade, building deep expertise in healthcare reimbursement and Medicaid financing strategies. He guides state Medicaid agencies through the development, implementation, and ongoing management of hospital prospective payment systems (PPS), including diagnosis-related groups (DRG), ambulatory payment classifications (APC), and enhanced ambulatory patient groups (EAPGs). His knowledge extends to long-term care hospital reimbursement methodologies, cost per diem rates, and physician payment systems utilizing the resource-based relative value scale (RBRVS).

His work includes analyzing Medicaid claims and expenditure trends, developing and managing complex datasets, and preparing policy recommendations that help states make informed reimbursement decisions. He designs and models claims-based payment systems, conducts fiscal analyses, and delivers detailed reports and presentations on complex reimbursement structures to state officials and industry stakeholders.

He has partnered with numerous Medicaid agencies to design and implement fee-for-service supplemental payment programs, managed care directed payment initiatives and preprint submissions, and Medicaid financing strategies,  including provider taxes, intergovernmental transfers (IGTs), and certified public expenditures (CPEs). He also manages daily operations for several Medicare upper payment limit (UPL) contracts, ensuring strict compliance with federal guidelines.

Joe serves on the Rate Setting and Federal Compliance engagement team and works out of the Kansas City office. He is a Certified Fraud Examiner and member of the Association of Certified Fraud Examiners.