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Healthcare Finance Update 2009: How to Cope With Bad Debt, Shrinking Charity & Reimbursement Level, and Expense Management
Joe Becht, Jr., CPA, FHFMA
P&P Board Vice Chair,Partner
Ernst & Young
Joe is a Partner in Ernst & Young’s Health Sciences Advisory Services practice with over 30 years of experience. Joe serves clients nationally with an emphasis on reimbursement, capital finance, mergers and acquisitions. Joe is one of the firm’s top reimbursement professionals and serves on Ernst & Young's National Reimbursement Task Force.
Experience
Joe has extensive background in health care reimbursement and finance with hospitals, health care systems, and long-term care providers. Specific examples of his experience include:
- Directs numerous third-party reimbursement engagements for health care systems and hospitals,
including DSH, Medicare Bad Debts, Wage Index, Medical Education, and Appeals.
- Testifies before the Provider Reimbursement Review Board (PRRB), Federal District Court, and at
numerous Medicare and Medicaid hearings.
- Performs merger and acquisition analyses for health care facilities including health care systems,
hospitals, nursing homes, ambulatory surgical centers, home health agencies, and physician practices.
- Serves as the lead Regulatory executive on several IRO/CIA engagements for Ernst & Young health care clients.
- Directs numerous financial feasibility studies for academic medical centers, acute care hospitals, nursing homes,
cancer centers, and continuing care retirement centers.
- Assists health care clients with developing and implementing strategic plans to respond to the changing health
care environment.
- Directs numerous hospital and health care system cost report reviews and optimization studies including having
developed the original home office cost reporting process for clients with Hospital, Nursing Home, Home Health,
Assisted Living, and Independent Living services.
- Conducts numerous presentations to Boards of Directors, Medical Staff, and Management teams
on reimbursement, compliance, capital finance, business planning, and managed care strategies.
- Directs corporate reorganization studies for health care systems.
Education and Affiliations
- Master of Business Administration in Finance from Virginia Commonwealth University
- Bachelor of Science in Business and Finance from Mount St. Mary's University
- Certified Public Accountant
- Certified Management Accountant
- Fellow of the Healthcare Financial Management Association
- Certified Managed Care Professional
- Certified Manager of Patient Accounts
Paul R. DeMuro
Partner
Latham & Watkins LLP
Mr. DeMuro is a partner in the Los Angeles and San Francisco offices of Latham & Watkins. He is
a CPA with an MBA in Finance who has practiced corporate and health care law since 1979. Mr.
DeMuro has practiced extensively in the areas of corporate transactions, joint ventures, mergers
and acquisitions (M&A), corporate organization, governance, finance, healthcare district law and
regulatory compliance. He also practices in the areas of Medicare reimbursement, fraud and
abuse, compliance and managed care. Mr. DeMuro primarily represents hospitals, health systems,
physicians, physician groups, physician practice companies, integrated health systems, managed
care organizations, e-health care and health care technology companies, and ancillary providers,
including laboratories, pharmaceutical companies, DME companies, clinics, home health agencies,
etc., commercial lenders and investment banks in health care transactions and in internal
investigations.
Mr. DeMuro has delivered throughout the world numerous presentations on health care issues and
has delivered more than 300 presentations on a national and regional basis over the last few years.
This coming year, among his many other presentations, he will be presenting at the ABA Health
Care Fraud Institute in Phoenix on Foundations of Health Law.
Mr. DeMuro is listed as a leading California Healthcare lawyer in Chambers and Partners USA –
America’s Leading Business Lawyers, 2007 and 2008. Chambers characterized him as having
“brilliant awareness of issues that can affect the healthcare sector and issues relating to healthcare
organizations.” LawDragon named Mr. DeMuro to its 2007 “500 Leading Deal Makers in
America,” and its 2005 “500 Leading Lawyers in America” list. He is listed as one of the leading
healthcare lawyers by Expert Guides. He was listed as an “Outstanding Healthcare Transactional
Attorney” by Nightingale’s Healthcare News (2003 and 2006) and has been listed in Who’s Who In
the World, Who’s Who in American Law, The Best Lawyers in America and SuperLawyers. Mr.
DeMuro also has been named one of the top 40 health care attorneys in the United States by the
National Law Journal and in the Los Angeles Business Journal’s Who’s Who in Health Care.
Education: JD, Washington University (St. Louis), 1979; MBA, University of California, Berkeley, 1986; BA,University of Maryland College Park, 1976 summa cum laude
Laura Ann Gabrysch
Sr. Associate
Fulbright & Jaworski L.L.P.
Laura Gabrysch's practice encompasses a wide variety of matters related to Federal and local taxation of corporations, partnerships, limited liability companies, and tax-exempt organizations. Laura's experience includes representing entities with respect to formation and operations, mergers and acquisitions, tax-free reorganizations, sales of businesses, deferred compensation, employment taxes, and general tax matters.
Additionally, Laura has substantial experience in advising and representing tax-exempt organizations on all matters related to tax-exempt status. This experience includes: conducting detailed tax compliance reviews; applying for and obtaining Federal and local tax-exempt status; structuring mergers, acquisitions, and other transactions; and advising clients with respect to governance, board fiduciary duties, joint ventures, physician and executive compensation, excess benefit transactions, tax-exempt bonds, state and local taxation, and taxation of related and unrelated income.
PROFESSIONAL ACTIVITIES AND MEMBERSHIPS: American Bar Association - Health Law Section; Tax & Accounting Interest Group, Chair and Hot Topics Editor; Participated in IG Working Group to prepare comments to Redesigned Form 990, 2007
AREAS OF CONCENTRATION: Tax; Health; Corporate;Corporate Governance;Probate and Fiduciary
PUBLICATIONS: Co-Author, "A Survey of New Developments in Tax-Exemption Law: What Compliance Officers Need to Know," Journal of Health Care Compliance, November/December, 2007
EDUCATIONAL BACKGROUND: 2001 - LL.M., Taxation, University of Florida Fredric G. Levin College of Law; 1996 - J.D., summa cum laude, St. Mary's University School of Law; 1988 - B.A., University of Texas
Laura served on the editorial board of the St. Mary's Law Journal and the Florida Tax Review. She was admitted to practice law in Texas in 1996.
CIVIC INVOLVEMENT: The Artist Foundation of San Antonio, Pro Bono Legal Counsel, Director and Immediate Past Chair
John Valenta, CPA, MBA
Senior Manager
Deloitte & Touche LLP
Mr. Valenta has 20 years experience in the healthcare and life sciences industries and advises clients on financial, regulatory and compliance issues. He has participated on numerous engagements with healthcare providers, payers and life sciences organizations and has extensive consulting experience on issues related to government program reimbursement, compliance, government regulations, internal controls and other financial issues. Recently, John has been assisting clients with issues related to the reporting of community benefits provided by not-for-profit hospitals and health systems in support of their tax-exempt status. This has included evaluating hospital’s pricing structure, including pricing strategy, financial modeling of the impact of pricing changes, pricing policies and procedures, charity care and comprehensive resource based pricing studies.
John has also been assisting clients with issues related to their compliance programs, including conducting effectiveness assessments as well as assisting with the development of compliance programs and ongoing auditing and monitoring activities. He has also assisted organizations with developing policies and procedures, providing education and evaluating the organizational structure of the compliance and internal audit functions. John also has been serving a number of the firm’s internal and external audit clients in the payer / provider setting as a subject matter expert covering areas related to internal controls and business processes, including cost reporting and government program billing issues.
John previously served as the Director of Reimbursement & Financial Analysis at a large academic medical center and is very familiar with the revenue cycle issues faced by healthcare providers from the front to the back end, including admitting/registration, billing, coding, pricing, chargemaster, cost reporting and other reimbursement issues. John has served clients by providing financial modeling and analysis of the impact of new Medicare prospective payment systems for skilled nursing facilities, outpatient hospital services, home health agencies and rehabilitation hospitals and units. Other examples of projects John has directed include cost report and reimbursement studies with an emphasis on DSH and medical education reimbursement, supporting attorney led investigations of billing, coding, and cost reporting issues, appeals of government program payment and certification determinations and corporate compliance program implementation and training for providers. He also has provided support on M&A engagements in the health care industry, performing diligence activities on reimbursement and compliance operations.
John is also a frequent speaker on Medicare and other governmental program reimbursement and regulatory issues facing providers, payers and life sciences organizations.
Healthcare Finance Update 2009: How to Cope With Bad Debt, Shrinking Charity & Reimbursement Level, and Expense Management
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