Since 2008, Performant has partnered with Centers for Medicare and Medicaid Services (CMS) to prevent, identify and recovery outstanding and improperly paid Medicare claims. We are proud to continue service as the Medicare Fee-for-Service Recovery Audit Contractor for two regions, including Region 1 and the National Contract for Region 5.
Our commitment is to deliver a best-in-class customer experience to the provider community and take extra efforts to minimize unnecessary burden during the course of our work. These efforts focus on collaborative and data-driven approach to apply learnings and continuously improve our auditing practices while reducing disruption.
If you have questions or would like to learn more about the CMS program, we're here to help. Talk with one of our friendly customer service specialists today.Contact us
Roxanne Cooksey, Project Manager - Region A, Region 1
Roxanne Cooksey is the Project Manager for Region A and Region 1. Roxanne has over 10 years of experience in the healthcare industry. During this time, she has managed and directed special projects and implementations. She has a strong track record of managing timely, complete, and accurate project deliverables as it relates to adherence to policy, regulatory compliance, contracts and statements of work. She continues to oversee the ongoing support for Region A contract close out activities and will serve as the Region 1 Project Director as well. She is the director of Healthcare Operations and Customer Service team in the San Angelo office and is actively involved in supporting audit delivery functions for the RAC Contracts. Overall, Ms. Cooksey is responsible to ensure the implementation of the RAC Contracts meet CMS requirements and the development of a good working relationship with all interested parties.
Ted Doyle, Project Manager - National Region 5
Ted Doyle is the Project Manager for the National Region 5 DMEPOS, Home Health, and Hospice Recovery Audit contract. Ted has over 32 years of experience in the healthcare industry with thorough knowledge of CMS Medicare and commercial healthcare coverage policies, procedures, and billing guidelines. Over his career he has been a senior leader with the CMS Program Integrity and Financial Management offices with Performant where he has been responsible for commercial clients' audit & investigation activities and also with multiple commercial healthcare insurers responsible for audit, investigations and analytics activities. Ted has over 20 years of experience serving as Project Manager with CMS and commercial healthcare insurers responsible for implementing and managing large scale service and systems delivery projects, conducting needs analysis, and developing and executing strategic plans. Overall, Ted is responsible to ensure the implementation of the National Region 5 RAC contract meets CMS requirements and development of a good working relationship with CMS, Providers, Industry associations and all interested parties and stakeholders.
Dr. Marlene Mullen-Clayton, Contractor Medical Director, Region 1
Dr. Mullen-Clayton serves as Contractor Medical Director for Region 1. She brings an extensive array of healthcare experience as an academician, physician and corporate leader.
Prior to joining Performant, Dr. Marlene Mullen-Clayton was the Northeast Regional Medical Director at United HealthCare focused on New Jersey managed Medicaid acute inpatient, skilled nursing facility, long term acute care hospital and acute inpatient rehabilitation services. In this role, and in her previous role as Chief Medical Officer of Premier Healthcare Exchange (PHX), Dr. Mullen-Clayton supported value based healthcare through medical necessity and policy review, peer interaction and stakeholder educational presentations. Prior to Joining PHX, Dr. Mullen-Clayton served as the Vice President of Medical and Clinical Operations for Executive Health Resources/Optum where she was a leader in the Strategic and Tactical Advocacy team. This team supported clients through OIG and DOJ investigations and developed concepts, products and position statements for internal and external clients. Prior to this, she managed the commercial appeals team and performed Medicare compliance reviews and appeals as a physician advisor for acute care hospitals across the Country.
Dr. Mullen-Clayton has nearly 20 years of clinical practice experience as an Emergency Medicine Physician and Medical Director She has held associate faculty positions at Thomas Jefferson University School of Medicine, MCP-Hahnemann School of Medicine and Drexel University. Dr. Mullen-Clayton received her medical degree from Philadelphia College of Osteopathic Medicine and her MBA from the University of Massachusetts Amherst. She is Board Certified in Emergency Medicine and is a Fellow of the American Association for Physician Leadership.
Dr. Mary Pascucci, Contractor Medical Director - National Region 5
Dr. Mary Pascucci serves as Performant Recovery's Contractor Medical Director for the CMS National DMEPOS, Home Health and Hospice Contract. Her leadership, education and experience serves as a valuable asset to the medical review and concepts teams.
Prior to joining Performant Dr. Pascucci acted as Performant's subcontracted Interim Medical Director. She was the Medical Director at Veritas MRS focused on the CMS Chronic Care Management program, DRG and InterQual review. Her role included physician-to-physician discussion, policy review, and ALJ interaction. Prior to Veritas, she was a Deputy Medical Director at the level of the QIC in charge of Physician Quality Control dealing primarily with DMEPOS, and also Part B Medicare. Dr. Pascucci's duties also included peer review for the VA System.
Dr. Pascucci has more than 20 years experience as an Anatomic and Clinical Pathologist with experience as a Laboratory Medical Director at multiple hospital based as well as privately owned laboratories. She is board certified in both AP and CP. Dr. Pascucci holds an adjunct faculty position at the Geisinger Commonwealth School of Medicine. Dr. Pascucci received her degree from Philadelphia College of Osteopathic Medicine and did her residency at Geisinger Medical Center. She is currently enrolled at St. Joseph's University in the Executive Healthcare MBA program.