Medicare payment systems are complicated.
I can help you make sense of them.
Practical advisory for healthcare organizations, technology companies, and government contractors navigating complex Medicare policy, payment, and operations challenges.
25 years inside CMS, now applied to your problem.
Nora rose from IT specialist to GS-15 Senior Advisor and Acting Director at the Centers for Medicare & Medicaid Services. Her career spanned Medicare fee-for-service payment policy, data systems, and the CMS Innovation Center — a rare combination of deep policy knowledge and operational fluency.
She has written proposed and final rules for Medicare acute and post-acute payment systems, designed and operationalized alternative payment models, and managed pricing software for every major Part A and Part B payment system. As Acting Director of the Chronic Care Policy Group, she led a team of 50 staff overseeing six post-acute payment systems.
Curious, practical, collaborative. She works best when she's digging into a real problem alongside your team — understanding the constraints, cutting through the complexity, and helping you find a path that actually works.
A rare combination of policy depth and operational fluency.
Expertise across policy, payment, and operations
Most advisors know one side of the picture. Nora has worked across Medicare payment policy, rulemaking, operational execution, data systems, and IT modernization — so she understands not just what the rules say but how they get implemented and where things break down in practice.
She has written the rules your organization responds to
Nora has authored proposed and final rules across Medicare acute and post-acute payment systems. That drafting experience gives her an insider’s understanding of regulatory intent, operational impact, and implementation risk to help you formulate an effective response.
Works across all sides of Medicare
Her practice serves healthcare organizations, health tech companies, government contractors, and federal agencies including CMS directly. That range means she understands the pressures and priorities on all sides of the table.
Practical, workable solutions
She doesn't arrive with a predetermined framework. She listens, gets into the details, and works with your team to find answers that hold up in practice. If there's a simpler path through a complex problem, she'll find it.
Engagements that require deep Medicare expertise and a practical eye.
Medicare FFS payment policy & operations
Acute and post-acute systems including IPPS, OPPS, SNF PPS, Home Health, Hospice, IRF, IPF, LTCH, ESRD. Policy design through operational implementation.
Rulemaking & regulatory guidance
Interpretation and analysis of proposed and final Medicare rules. Effective comment letters and response strategies grounded in firsthand drafting experience.
Fee schedule expertise
Physician, Ambulance, ASC, Clinical Lab, DME, and ASP drug pricing. Annual rulemaking cycles and the operational changes that follow.
CMMI innovation & alternative payment models
Model design, operational execution, financial modeling, and stakeholder engagement for bundled payments, specialty episodes, ACOs, and Part B drug models.
IT modernization & data strategy
Medicare payment system modernization, cloud migration, AI integration, and data interoperability — grounded in direct CMS project leadership.
Contract & proposal support
Capture strategy, technical approach, and requirements translation for organizations pursuing or executing CMS work.
Deep familiarity across the Medicare landscape.
Healthcare, tech, and government — across the table.
No sales pitch.
Just a direct conversation.
Tell me about the problem you're trying to solve. If I can help, we'll talk about how. If I can't, I'll often know who can.