Professionals

Sheila Madhani

Senior Director


Education

Johns Hopkins University, Bloomberg School of Public Health, M.P.H., 2006

University of Chicago School of Social Service Administration, M.A., 1997

University of Chicago, B.A., 1993

Sheila Madhani

Sheila advises clients on a wide variety of Medicare payment and regulatory issues. With more than 10 years of experience, Sheila is highly skilled in the areas of Medicare physician and hospital outpatient payment, Medicare quality programs, and the establishment and valuation of CPT® codes. Sheila has a deep understanding of emerging technology’s impact on Medicare reimbursement. She has facilitated relationships and discussions with physician specialty societies and industry stakeholders, helping to develop mutually beneficial collaborations. Sheila also has guided clients on working with the U.S. Centers for Medicare and Medicaid Services (CMS), and steered them through the American Medical Association’s CPT® Editorial Panel and RVS Update Committee (RUC) processes.

Prior to joining McDermottPlus, Sheila worked on behalf of physician specialty societies, trade associations and medical technology companies, serving as lead staff on Medicare reimbursement and coding issues.

Representative Experience

  • Analyze Proposed and Final Rule changes concerning Medicare payment and policies (e.g., Medicare Physician Fee Schedule, Outpatient Prospective Payment System, Ambulatory Surgery Center fee schedule) and publicly available Medicare data (including payment, cost, and utilization data) to evaluate, develop and implement client strategies.
  • Facilitate relationships between providers, industry and payors. 
  • Manage client participation in the American Medical Association CPT® Editorial Panel and RVS Update Committee processes from submission of code application to physician work and practice expense recommendation development.
  • Develop and conduct Medicare training for clients, including technology companies and trade associations. 

Publications

  • "Radiation Oncology: A Perspective on Health Reform and Value Based Initiatives", Journal of Oncology Practice, June 2014 (co-author)
  • "Gastroenterologists' Experience with the 2007 Physician Quality Reporting Initiative", Gastrointestinal Endoscopy (GIE), March 2009 (co-author)
  • "GI Experience with the Physicians Quality Reporting Initiative (PQRI): A Demonstration Project", Poster Presentation at Digestive Diseases Week (DDW) 2008, July 2008 (co-author)
  • "Innovative Programs for Children 0-3 at Safety Net Institutions" (co-author) Commonwealth Fund; September 1999

Education

Johns Hopkins University, Bloomberg School of Public Health, M.P.H., 2006

University of Chicago School of Social Service Administration, M.A., 1997

University of Chicago, B.A., 1993