Bob De Luca joined IMA Consulting as a Partner in 2003. He has over 25 years of experience exclusively in the healthcare industry and is the leader of IMA Consulting’s Regulatory Consulting Practice. Bob has extensive expertise in Medicare regulatory matters including both prospective and cost-based payment system issues, development and implementation of compliance related initiatives, and hospital merger and acquisition related matters. He has provided expert witness testimony at PRRB hearings, represented numerous provider clients in appeals at both the Medicare fiscal intermediary and CMS Regional and National levels, and has assisted many providers and their legal counsel in responding to various OIG/DOJ investigations.
Consulting engagements have included:
While with PricewaterhouseCoopers, LLP (formerly Coopers & Lybrand LLP), Bob acted as principal negotiator in the settlement of over $500M in Medicare claims for the largest privately held home health agency in the United States. Convictions of key senior management officials, including the CEO/owner for Medicare fraud, forced the Company into bankruptcy and eventual sale. Negotiations took place directly with CMS’ (then HCFA) Office of General Counsel and formed the framework for the Company’s settlement with CMS, the HHS OIG and the Department of Justice. For his efforts on this engagement, Bob was awarded the 1997 TMA Turnaround of the Year – Large Company.
As a Partner at PwC, Bob structured various hospital and health system sale, statutory merger, and consolidation transactions with a focus upon Medicare loss on sale / depreciation recapture implications and the related impacts upon Medicare Capital PPS payments and terminating cost report issues. Analysis also included “after sale” regulatory review of combining Medicare provider numbers and the related effect on GME, IME, and DSH adjustments as well as TEFRA target rates for PPS-exempt units. He participated as a key member of a regulatory, legal, and provider team involved in the negotiation of the first Medicare/Medicaid Voluntary Disclosure case in the United States. The settlement related to a multi-specialty physician practice plan and involved direct discussions with local and national OIG officials as well as the United States Attorney’s Office.
Bob earned his Bachelor of Science in Accounting from Saint Joseph’s University. He is a Certified Public Accountant in the Commonwealth of Pennsylvania. Bob’s professional affiliations include the American Institute of Certified Public Accountants, the Pennsylvania Institute of Certified Public Accountants, and the American Health Lawyers Association. Bob was the 2002-2003 President of the Metropolitan Philadelphia Chapter of the Healthcare Financial Management Association (HFMA).