November 9, 2012 - Revised: 09.12.14
Meet the CGS Medical Directors
CGS has recently hired new Medical Directors for our Part A, Part B, and Home Health and Hospice segments of business. All three have extensive medical backgrounds, as well as education and leadership qualities, and we are thrilled to welcome them to CGS.
Kentucky and Ohio Part A: Neil Sandler, MD
Dr. Neil Sandler attended SUNY @ Stony Brook, obtaining a bachelors degree in biology in 1978. He obtained a Doctorate in Medicine from New York Medical College in 1982 and became board certified in internal medicine in 1985. He practiced emergency medicine and internal medicine for 15 years. His administrative experience spans 19 years on the payer side including medical director for a large managed care company managing commercial, managed Medicare and managed Medicaid populations, a Medicare Contractor Medical Director, a medical director for a payment policy and clinical editing company where he managed payment policy for over $5B in annual claim volume and a consultant to both the pharmaceutical and medical device industry and the investment community. Dr. Sandler has recently joined CGS Administrators as Chief Medical Officer for Part A Medicare and Home Health and Hospice. He is looking forward to establishing strong, professional relationships with the provider community to facilitate mutual goals and outcomes and welcomes your thoughts and opinions.
Kentucky and Ohio Part B: Earl Berman, MD
Dr. Earl Berman, a native of Savannah, GA, attended Benedictine Military School, the University of Georgia, and Medical College of Georgia. He has been in the practice of general internal medicine for over 20 years in diverse practice environments. He has practiced in large multi-specialty groups/clinics, urban private practice, rural private practice, sports medicine, student health, hospice, nursing homes, and assisted living. His administrative experience includes being a managing partner in an internal medicine group, managing a five county sports medicine practice, hospice medical director, Medicare CMD for Part B GA, RAC CMD for PRGX auditing 14 states for Medicare and other private/government contracts, and now CMO for CGS. Dr. Berman prides himself in being available to discuss issues promptly and professionally. He also promotes the four cornerstones of communication: clear, concise, correct and considerate.
Home Health and Hospice: Kenneth McDonough, MD
Kenneth McDonough has focused his career on advancing clinical decision support to promote cost effective quality care. Both population management and health risk appraisal applications have been designed by him. As the chief medical officer for a Medicare fiscal intermediary, he developed claims payment, provider education and utilization management systems. His responsibilities included relative value based reimbursement, medical policy and technology assessment. Dr. McDonough created programs for catastrophic case management and centers of excellence focusing on morbidity and mortality reduction. He consulted with health plans on evidence based medicine, geriatric disease management, health economics, fraud, predictive modeling and formulary value. His leadership roles included the Health Insurance Association of America's chair for provider relations and technology assessment as well as the Disease Management Association of America's board of directors and National Committee for Quality Assurance's state of our health steering committee. Dr. McDonough obtained a medical degree and masters of informatics at the University of Minnesota. Creighton University School of Medicine and Monmouth University Graduate School of Business appointed him as adjunct faculty.
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