Gina M. Reese, RN, JD, is an expert in Medicare rules and regulations and is an instructor for HCPro's Medicare Boot Camp-Hospital Version®, Utilization Review Version® and Provider-Based Departments Version®. She is also the author of Provider-Based Entities: A Guide to Regulatory and Billing Compliance, published by HCPro. As a registered nurse and attorney, Ms. Reese has specialized for more than 30 years in assisting health care providers in Medicare regulatory interpretation, survey preparation, compliance with Medicare certification and Joint Commission accreditation requirements, responses to adverse certification/accreditation findings, appeals of reimbursement disputes, utilization management, and representation in fraud/abuse investigations and disclosures.

Ms. Reese graduated Magna Cum Laude from Whittier College School of Law in Los Angeles, after receiving a Bachelor’s Degree in Business Administration with an emphasis in Accounting, Magna Cum Laude, from California State University at Los Angeles, and a Nursing degree from Samuel Merritt Hospital School of Nursing in Oakland, California. Ms. Reese specialized in pediatric intensive care, chemotherapy and diabetic care/education at University Hospital in San Diego and Childrens Hospital at Los Angeles (CHLA). She then moved into a position as supervisor in utilization management and quality review at CHLA, overseeing a cadre of nurses performing these tasks, staffing peer review, UM and quality committees at the hospital and drafting and managing policies and procedures for these activities. While attending law school, Ms. Reese accepted a position at Shriners Hospital for Crippled Children, Los Angeles, as the Director of Risk Management, Quality Assurance and Utilization Management.

After completing law school, Ms. Reese provided legal services for 10 years at Hooper, Lundy and Bookman, a boutique health law firm in Century City, California, representing health care providers across the country. For the next 10 years, Ms. Reese worked as Senior Counsel at Kaiser Foundation Health Plan/Hospitals, further broadening her knowledge of health care law to include managed health care, provider contracting, Medicare Advantage (including risk adjustment), revenue cycle, coding, privacy, electronic health records, and many other areas. Ms. Reese then became the Director of Risk Management at an acute care hospital in Southern California for 9 years, and is a Certified Professional Risk Manager through the American Hospital Association. In that capacity, she performed Medicare One Day Stay reviews and supported the Utilization Review Committee.