# Applied Policy

> Applied Policy is an Alexandria, Virginia health policy and reimbursement consultancy founded by former Senate legislative counsel and CMS adviser James G. Scott. It helps healthcare providers, life sciences companies, device and diagnostic manufacturers, associations, innovators, and investors understand or change the coding, coverage, payment, and legislative rules that determine whether medical products and services reach patients.

- **Founded:** 2009
- **Headquarters:** Alexandria, United States
- **Founders:** James G. Scott (Founder, President and CEO)
- **Products:** Medicare reimbursement, Medicare market access, CMS rule navigation, Quality programs, Legislative drafting and analysis
- **Notable:** Identified erroneous CMS hospital outpatient payment status indicators affecting a client’s drugs and helped secure corrected, retroactive reimbursement so denied claims could be resubmitted., Helped persuade a Midwestern Medicaid program covering more than 700,000 beneficiaries to permit clinically justified insulin-pump replacement before warranty expiration., Guided a physician-owned hospital through a CMS expansion exception; the hospital was one of only five nationwide approved during the two-year application period.

## Products & services

- **Medicare reimbursement** — Coding, coverage, payment strategy, reimbursement troubleshooting, and engagement with CMS and Medicare contractors.
- **Medicare market access** — Coverage and payment planning for drugs, devices, diagnostics, and emerging healthcare products from development through commercialization.
- **CMS rule navigation** — Monitoring, interpretation, impact analysis, comments, and response strategies for CMS rules and guidance.
- **Quality programs** — Policy and implementation support for provider quality and value-based payment programs.
- **Legislative drafting and analysis** — Drafting legislative language, analyzing proposals, estimating practical effects, and building stakeholder strategies.
- **Healthcare policy development** — Research, coalition engagement, policy design, white papers, formal comments, and advocacy execution.
- **Applied Policy Insight and policy forums** — Public analysis through a newsletter, podcast archive, rule summaries, and the sponsored Northern Virginia Health Policy Forum.

## Achievements

- Identified erroneous CMS hospital outpatient payment status indicators affecting a client’s drugs and helped secure corrected, retroactive reimbursement so denied claims could be resubmitted.
- Helped persuade a Midwestern Medicaid program covering more than 700,000 beneficiaries to permit clinically justified insulin-pump replacement before warranty expiration.
- Guided a physician-owned hospital through a CMS expansion exception; the hospital was one of only five nationwide approved during the two-year application period.
- Secured New Technology Add-On Payment approval for a new inpatient antibiotic and supported CMS provider education needed for hospitals to bill correctly.
- Helped a durable medical equipment supplier enroll for QMB-only Medicaid claims and obtain crossover reimbursement for diabetes equipment supplied to dual-eligible beneficiaries.
- Built a graduate medical education policy campaign that gained support from 37 members of Congress.
- Founder James Scott was recognized for work supporting implementation of the Medicare prescription drug benefit and for drafting major Medicare legislation before founding the company.

## Latest updates

- **2026-09** — Published analysis of the September 2026 MedPAC meeting and CMS pathways for medical devices.
- **2026-08** — The Northern Virginia Health Policy Forum examined international reference pricing in new CMMI drug-pricing models.
- **2026-08** — Posted openings for a Health Policy Manager focused on devices and diagnostics and for a part-time health policy intern.
- **2026-06** — Hosted public forum conversations on Medicare Parts C and D and the future of Medicare accountable care organizations.
- **2026-04** — Published a detailed summary of CMS proposals for drug prior authorization and interoperability standards.

## Links

- Website: https://www.appliedpolicy.com/
- LinkedIn: https://www.linkedin.com/company/applied-policy
- Twitter/X: https://www.twitter.com/appliedpolicy

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Profile page: https://yespress.io/applied-policy
Published by YesPress — https://yespress.io
Last updated: 2026-09-21