Dr. Kenneth M. Nelson, MD, MPH, CFE, is a Senior Advisor to Aledo Consulting. He has extensive experience in government Medicare and Medicaid programs, as well as the private sector. He has over 30 years of experience in healthcare including twenty years as Medical Advisor, Office of Inspector General, US Department of Health and Human Services and ten years in leadership positions in government contractors Palmetto Government Benefits Administrators - where he served as Medical Director for the Medicare Durable Medical Equipment national contractor (SADMERC)- and at TriCenturion - where he focused on program integrity and compliance issues. At the SADMERC, he was intimately involved in the coding, coverage, and pricing of Durable Medical Equipment..
His current interests include the appropriate coding and payment for new and improved items of Durable Medical Equipment and related procedures under the HCPCS and CPT coding systems. Building on his five years of service as the only non federal employee serving on the Alpha-Numeric Work Group which codes durable medical equipment and other items for CMS (Medicare) reimbursement, he is fully familiar with the pitfalls that may be encountered in that process.
Dr. Nelson received his BA with honors and his MD from Columbia University and his MPH from the Johns Hopkins University School of Hygiene and Public Health. He has served as an Associate Division Director, National Cancer Institute and as a Health Fellow in the United States Senate. He is the author of over a dozen publications in healthcare management, clinical, and basic research.