As Manager, Adam Fowler monitors the latest legislative and regulatory developments across the country affecting our division and the services we provide our clients. He analyzes changes and engages with state regulators through informal conversations and participation in formal rule-making processes. Adam communicates new legislative and regulatory requirements internally and serves as a subject matter expert in compliance projects and initiatives, in addition to assisting with client education on policy changes.
Adam’s particular areas of focus involve health care provider billing regulations and state medical EDI reporting. Additionally, he provides advice and education to regulators in their development of state drug formularies. He is also the leader of NCPDP’s Work Group 1–Workers’ Compensation Monitoring, Billing and Education Task Group where he facilitates group discussions on pending and adopted public policy changes relating to workers’ compensation and auto no-fault pharmacy services, and he works internally within NCPDP to address updates to the pharmacy billing standards needed as a result of those changes. Adam is also an active member of the IAIABC EDI Medical and ProPay Committee, assisting with maintaining the IAIABC workers’ compensation billing and reporting standards and related educational resources, in addition to assisting regulators with adoption of those standards.
Prior to joining Optum in 2010, Adam worked for a member of the Florida House of Representatives, for the Hillsborough County Supervisor of Elections and as a member of the Tampa Tribune’s inaugural Board of Community Columnists.
Adam earned his Master of Arts and Bachelor of Arts degrees in Political Science from The University of South Florida.
Medical and pharmacy billing
State medical EDI reporting
Workers' comp regulation