Our Team


Thomas E. Herrmann, JD

THOMAS E. HERRMANN, JD     
Vice President

5911 Kingstowne Village Parkway,
Suite 210
Alexandria, VA 22315

(P) (703) 683-9600  
(F) (703) 836-5255  
therrmann@strategicm.com 

AREAS OF FOCUS

Independent Review Organization (IRO) activities
Medicare Appeal Strategies
Medicare Overpayment Assessments (by RACs and CMS)
Self Disclosure
Due Diligence Reviews
Independent Verification Reviews
Medicare Anti-Kickback Statute and Stark Law Issues
EMTALA
Administrative Sanctions Imposed by HHS (civil money penalties and program exclusion)

INDUSTRY SPECIALITIES

HOSPITALS/HOSPITAL SYSTEMS
PHYSICIAN PRACTICES
LONG TERM CARE
MANAGED CARE

PROFESSIONAL EXPERIENCE

Mr. Herrmann joined Strategic Management in January 2009 upon his retirement from Federal Service.   Since joining the firm, he has assumed responsibility for a variety of client-related activities.  These include handling the Independent Review Organization (IRO) responsibilities that SM is undertaking on behalf of a large managed care organization.  He is also engaged in developing Medicare claim appeals strategies for clients, focusing on the Administrative Law Judge and Medicare Appeals Council levels of review. In conjunction with these activities he has given presentations at various health care forums on appeal issues related to denials/overpayments assessed by the new Medicare Recovery Audit Contractors (RACs). 


Mr. Herrmann has also conducted due diligence reviews of health care entities related to a proposed business relationship, acquisition, or merger.  In many instances, these reviews have related to the appropriateness of arrangements under the Medicare/Medicaid Anti-Kickback Statute and the Stark Law (pertaining to physician self-referrals). In addition, he has undertaken independent verification reviews preliminary to a health care provider self disclosure to Governmental authorities.




PREVIOUS WORK
Mr. Herrmann has over 30 years of legal experience with the U.S. Department of Health and Human Services (HHS).  Most recently (2002-2008), he served as an Administrative Appeals Judge on the Medicare Appeals Council, the final level of HHS administrative review.  In that capacity, he adjudicated health care provider, supplier, and beneficiary cases involving eligibility, coverage, and payment for health care services furnished to Medicare beneficiaries. 


For the prior 20 years, Mr. Herrmann held various positions in the HHS Office of Inspector General (OIG).  He was Acting Director of the Office of External Affairs in OIG, and supervised various divisions, including the Offices of Congressional Affairs, Public Affairs, and Freedom of Information Act.  He also served in various management and staff attorney positions in the Office of Counsel to the Inspector General (OCIG).  He both managed and personally handled administrative litigation involving the imposition of civil money penalties and program exclusion, and coordinated with the U.S. Department Justice and the Centers for Medicare & Medicaid Services (CMS) the investigation, litigation, negotiation, and settlement of health care fraud and abuse cases.   His responsibilities included reviewing and deciding requests for reinstatement to federal health care programs filled by health care providers and suppliers following a period of program exclusion, and serving on the Federal Interagency Suspension and Debarment Coordinating Committee.


EDUCATION/AFFILIATIONS/RECOGNITION
Bachelor of Arts, Political Science, State University of New York at Stony Brook
Juris Doctor, George Washington University National Law Center
Member, District of Columbia and Virginia Bars
Member, American Health Lawyers Association


PUBLICATIONS/PRESENTATIONS

Compliance in an Era of Health Care Reform, Health Care Compliance Association, Annual Compliance Institute, April 2010. [HTML] [PDF]


Independent Review Organizations Must Meet GAO Yellow Book Standards, Journal of Health Care Compliance, March-April 2010. [HTML] [PDF]


The RAC Appeals Process, October 2009. [HTML] [PDF]


RAC Appeals - Strategies and Defenses for Overturning Hospital RAC Denials, Health Care Compliance National Audio-Conference, May 2009. [HTML] [PDF]


The Medicare Appeals Process: A Decade of Change, American Health Lawyers Association, Institute on Medicare/Medicaid Issues, March 2009. [HTML] [PDF]


Durable Medical Equipment Documentation Required for Medicare Payment, Journal of Health Care Compliance, January 2009. [HTML] [PDF]


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