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Nuts and Bolts of Medicare and Medicaid 2018: What All Attorneys Need to Know

Speaker(s): Beth Shyken-Rothbart, Caroline L. Farrell, Chad Shearer, Edo Banach, Valerie J. Bogart
Recorded on: Dec. 7, 2018
PLI Program #: 220440

Chad Shearer is Vice President for Policy at the United Hospital Fund (UHF) where he oversees work to build a more effective health care system in New York through initiatives focusing on children’s health, innovation, insurance and Medicaid. He leads a team of experts engaged in policy and health system landscape analysis, identification and promotion of delivery system and payment reform innovations, and convening diverse audiences to collaborate on major health policy issues in New York. Mr. Shearer also directs UHF’s Medicaid Institute, conducting data and policy analyses explaining New York's Medicaid program which serves over 6 million low-income New Yorkers at a cost of over $60 billion annually.

Previously, Mr. Shearer was at the Woodrow Wilson School of Public & International Affairs at Princeton University, where he served as deputy director of the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, a project coordinating technical assistance to 11 states implementing the Affordable Care Act’s coverage expansion provisions. He was also a lecturer in public affairs at the university, teaching a capstone policy workshop. Mr. Shearer also spent time at the Center for Health Care Strategies, where he helped shape its Medicaid Leadership Institute. Before that, he served as legislative director for Congressman Pete Stark, who was Chairman of the Ways and Means Subcommittee on Health, in the United States House of Representatives.

Mr. Shearer holds both law and master of health administration degrees from the University of Iowa.

Valerie Bogart has directed the Evelyn Frank Legal Resources Program (EFLRP) since 2002.  Launched by Selfhelp Community Services, EFLRP moved to the New York Legal Assistance Group, under Valerie’s leadership, in 2013.   EFLRP represents low-income seniors with Medicaid and Medicare advocacy, trains and consults with professionals on navigating the complex world of Medicaid and long-term care, engages in policy advocacy to improve access to services, and co-maintains the website as a joint project with The Legal Aid Society and Empire Justice Center.

Earlier, Valerie was a staff attorney for the Legal Aid Society Brooklyn Office for the Aging, Legal Services for the Elderly (Manhattan), and the Legal Aid Society (Minneapolis), where she was a Reginald Heber Smith Fellow.  She was co-counsel on law reform litigation that protects rights of Medicaid home care recipients,  including DeLuca v. Hammons, 927 F. Supp. 132 (S.D.N.Y. 1996)(lifting 28-hour-per-week limit for new applicants);  Granato v. Bane, 74 F.3d 406 (2d Cir. 1996)(requiring reinstatement of Medicaid home care services after a temporary hospital stay); Varshavsky v. Bane, 608 N.Y.S.2d 184 (1st Dep't 1994)(requiring  reinstatement of State “homebound hearing” program); Sanon v. Wing et al.,  2000 N.Y. Misc. LEXIS 139 (Sup. Ct. N. Y. Co.)(enjoined state “fiscal assessment” law pending analysis of whether the denial of Medicaid home care services if nursing home care was less expensive violates the Americans with Disabilities Act); and Brown v. Giuliani, 2000 U.S. Dist. LEXIS 8889 (S.D.N.Y. 2000)(suit by 282 former residents of the Neponsit nursing home challenging the abrupt evacuation and closing of the home by its operator, the NYC Health & Hospitals Corporation).

A graduate of the New York University School of Law, she lectures extensively for bar and social services organizations, has taught adjunct courses at CUNY and Fordham Law schools, and has received numerous awards for her advocacy.   She is Vice-Chair of the Legislation Committee and previously Co-Chair of the Medicaid Committee of the New York State Bar Association Elder Law Section.

Beth Shyken-Rothbart is the Senior Counsel for Client Services and New York Policy at the Medicare Rights Center. Medicare Rights is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives. Beth provides individual counseling to Medicare beneficiaries, caregivers, and professionals, as well as represents individuals in Medicare appeals. She also provides assistance to dual eligible individuals in New York who receive Medicaid managed long term care services. Additionally, Beth contributes to Medicare Rights Center’s policy initiatives both federally and in New York State. She holds a B.A. from the University of Michigan, a M.Ed. from DePaul University, and a J.D. from City University of New York School of Law. She is admitted to practice in New York.

Caroline Farrell is an attorney in the Office of the General Counsel, Centers for Medicare & Medicaid Services (CMS) Division at the U.S. Department of Health and Human Services.  In this role, she is primarily responsible for providing advice and counsel to CMS on legal issues arising under the Medicaid program.  Other areas of her practice include advising CMS’ Medicare-Medicaid Coordination Office on its Financial Alignment Initiative and the Center for Medicare and Medicaid Innovation on ACO models.  Prior to joining OGC, Caroline served as an analyst in the Medicare Drug & Health Plan Contract Administration Group at CMS.  Caroline received a Bachelor of Arts degree and a Master of Public Health degree from the George Washington University, and her J.D. from the University of Maryland School of Law, where she served on the Maryland Law Review.

Edo Banach is President and CEO of the National Hospice and Palliative Care Organization

Prior to that, he was Partner in the firm of Gallagher, Evelius & Jones in Baltimore, MD.  He previously was the Deputy Director of the Medicare-Medicaid Coordination Office at the Centers for Medicare & Medicaid Services and Associate General Counsel at the Visiting Nurse Service of New York.  Prior to that, Edo Banach was the Medicare Rights Center’s General Counsel.  Edo also practiced health law at the firm of Latham & Watkins and clerked for U.S. Judge John T. Nixon of the Federal District Court for the Middle District of Tennessee.  Prior to attending law school Edo worked for the New York City Department of Homeless Services and Mayor's Office of Operations. Mr. Banach holds a B.A. from Binghamton University and a J.D. from the University of Pennsylvania Law School.