Tom Entrikin

A former policy specialist with the U.S. Health Care Financing Administration (now Centers for Medicare & Medicaid Services (CMS)), Tom Entrikin has vast experience providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; and Medicaid waiver programs. Since joining PCG in 1992, Tom has assisted in the design, development, and implementation of revenue projects for school-based health services; hospital-based and municipal projects for pregnant women, infants, and children; state services offered through youth services, child welfare, mental health, substance abuse, and public health agencies; and reimbursement systems for hospitals, long term care facilities, and community-based waiver programs. He has made presentations at national conferences on Medicaid waiver programs and participated in the development of a manual on self-determination under waiver programs for the Robert Wood Johnson Foundation.

• Medicaid and Medicare policy and programs

Tom has over 30 years of experience in Medicaid and Medicare policy and programs. He worked for 15 years for the Health Care Financing Administration, U.S. Department of Health and Human Services (HCFA, now CMS) before joining PCG. While at HCFA, Tom was the principal liaison between HCFA and the Vermont, Connecticut, and Massachusetts Medicaid programs. His responsibilities included state plan amendments, waivers, interagency agreements, managed care, development of capitation rates, third party liability recoveries, management information systems, program integrity, EPSDT requirements, and policies on eligibility, reimbursement, and service coverage. He received a HCFA Administrator’s Citation for his work achieving savings in Medicaid prescription drug reimbursement systems. Since joining PCG, Tom has worked with numerous clients, including state health and human services agencies in Colorado, Connecticut, Delaware, Kentucky, Maryland, Massachusetts, New Hampshire, North Carolina, Ohio, Rhode Island, Tennessee, Texas, Washington, and West Virginia.

Articles

Managed Care in the Medicaid Program

June 1994

Beyond Managed Care: An Owner’s Manual for Self-Determination

T. Nerney, D. Shumway, M. Fenton, T. Entrikin, S. Morrill, G. Marburg, published - by Robert Wood Johnson Foundation, 1997

Tom Entrikin is a regular contributor to PCG's Health and Human Research blog. Click here to view his past posts.

   To learn more about Tom Entrikin or other PCG Health and Human Services Subject Matter Experts, contact us at pcghhs@publicconsultinggroup.com or 1-800-210-6113.