Tami, a member with Myers and Stauffer, has more than 25 years of experience in health care auditing and consulting. Her areas of expertise are in the audits of nursing facilities and home offices, managed care organization (MCO) cost review and verification, litigation support for nursing facilities, and Centers for Medicare & Medicaid Services (CMS) Payroll-Based Journal (PBJ) audits.
Some of her current responsibilities include managing the long-term care (LTC) portion of a state Medicaid auditing contract. This includes planning, performing, and reviewing the verifications of more than 250 cost reports per year, as well as participating in the appeal process by writing and reviewing position papers to defend the clent’s position, participating in settlement negotiations and testifying as an expert witness in both civil and criminal proceedings. Tami has consulted with the states on the design and implementation of a prospective payment rate system for LTC providers, and assists the client with the design and implementation of a minimum data set (MDS) validation program. She is also responsible for agreed-upon procedures (AUP) engagements for MCOs. These engagements include the review of cost data, a detailed claims review, and verification of procedures used by the MCOs to record data in prescribed forms. Tami serves as the quality director on the firm’s electronic health records (EHR) contract with the state of Maryland, and is a co-project lead on a contract with CMS to audit their national PBJ system.
Tami’s prior experience includes managing a certified public accounting (CPA) firm’s national health care practice. She led efforts to secure new business, and developed systems to identify health care engagement opportunities for the firm. She also served as a senior manager with another CPA firm, managing the LTC portion of a state Medicaid auditing contract. Tami’s responsibilities included preparing and presenting the client’s position at Medicaid cost settlement appeals hearings; testifying as an expert witness in nursing home provider Medicaid cost settlement appeals; managing the Medicaid reimbursement rate setting and rate revision process for nursing home providers; managing AUP engagements for the verification of data submitted by managed care providers; and reviewing audit working papers for compliance with audit program requirements and with Medicare and Medicaid principles of reimbursement.
Tami takes an active role in mentoring and coaching staff and managers in the firm. She is a member of Myers and Stauffer’s Perform, Excel, Advance, Know (PEAK) Leadership Development Committee, and is assisting in the design and implementation of the firm’s Mentoring Program.
Tami is a Certified Public Accountant (CPA) and an active member of the American Institute of Certified Public Accountants, and the Maryland Association of Certified Public Accountants. Tami is also a Towson University Accounting Advisory Board Member and a member of the Bike Maryland board of directors.
- Audits of nursing home facilities and home offices.
- Litigation consultation and support.
- Design, development, and implementation of case mix rate setting systems.
- Consultation on Medicaid rules and regulations for Maryland.
- Verification of managed care costs and claims data.
- Design and implementation of CMS PBJ national auditing protocol.
“Our clients know they are our top priority. They don’t have to worry about the quality of our work, our deadlines, or our integrity. That is why so many states trust and depend on Myers and Stauffer.”
— Tami Bensky