John Warren

Independent Healthcare Consultant

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Ask me about
Medicare policy
NTAP
CMS
Medicare
physician payment
CMS
Physician Fee Schedule
Outpatient payment
Durable Medical Equipment
prescription drugs
drug pricing
Medicaid
Pharmaceutical Consulting
medical coverage
CPT coding
HCPCS coding
OPPS
IPPS
Inpatient prospective payment system
inpatient
inpatient hospital
outpatient
outpatient prospective payment system
ASP
Average Sales Price
Part B Drugs
Part D
Work experience

Jan 2020 - Present

Gettysburg Healthcare Consulting

Owner & Principal Consultant

John works with clients in the healthcare sector to successfully commercialize and secure payer acceptance of novel and innovative technologies. John uses his knowledge of the Medicare program and its varied payment methodologies, including fee-for-service, capitated payments, prospective payments and other competitive fee setting systems along with a comprehensive understanding of Medicare rules and legislative requirements to help his clients best position their products, which include diagnostic tests, medical devices and other services, for successful coverage, coding and payment from third party payers.

Mar 2014 - Jan 2020

McDermott+Consulting

Senior Director

As the Senior Director of Health Policy in the consulting firm of McDermott+Consulting I will be using my 20+ years of experience as a leader and senior technical advisor at the U.S. Centers for Medicare and Medicaid Services (CMS) to advise clients on Medicare and Medicaid policy and advocacy strategy, as well as interactions with the agency.

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Jan 2013 - Mar 2014

McDermott Will & Emery

Senior Director for Health Policy

As the Senior Director of Health Policy in the consulting firm of McDermott+Consulting I will be using my 20+ years of experience as a leader and senior technical advisor at the U.S. Centers for Medicare and Medicaid Services (CMS) to advise clients on Medicare and Medicaid policy and advocacy strategy, as well as interactions with the agency.

Feb 1992 - Jan 2013

Centers for Medicare and Medicaid Services

Health Insurance Specialist

I consulted, on an as needed basis with various components within CMS. Recently, I worked with the Center for Medicare Innovation during the development of the Community Primary Care Improvement process. I also analyzed contract proposals from Medicare Administrative Contractors to determine whether their budget proposals are realistic.

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Feb 2006 - Nov 2011

Centers for Medicare & Medicaid Services

Director, Division of Ambulatory Services

Direct the development of payment policy for a variety of Medicare Part B services including physician administered drugs, ambulance, clinical laboratory tests, rural health clinics and federally qualified health centers

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Jan 2006 - Jun 2006

Centers for Medicare & Medicaid Services

Acting Director, Division of Practitioner Services

I directed the development of the Medicare Physician Fee Schedule, the document that establishes new Medicare payment polices each year. With emphasis on misvalued services, physical therapy caps and other provider payment related issues.

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Jan 1998 - Jan 2006

Centers for Medicare & Medicaid Services

Director, Division of Medical Review and Education

Directed the development of medical review policy and the implementation of medical review strategies at Medicare contractor sites nationwide.

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