Richard Hughes IV

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Bio

Richard Hughes IV, J.D., M.P.H. is a Professorial Lecturer in Health Policy & Management and Vice President of Policy & Strategy with Avalere Health, a Washington health care advisory services firm. Professor Hughes is a strategic advisor to health care entities and has taught in the areas of health law and policy at both the undergraduate and graduate levels. At Avalere, he leads multidiscplinary teams of professionals with special focus in vaccines and preventive services, state health policy and health sector strategy.

Professor Hughes is formerly a practicing attorney with the Washington law firm Epstein Becker Green, where he advised health care entities on a range of legal, regulatory and policy matters. Prior to practicing law, Professor Hughes served in several health policy leadership roles. He was a gubernatorial appointee to the Arkansas State Board of Health, where he deliberated public health policy, co-presided over appeals before the state health department, and actively spoke on numerous health policy issues. Professor Hughes then served as Director of State Health Policy at the Association of State and Territorial Health Officials, and later as Associate Director of Policy with Merck & Co., Inc., advising and working with state health agencies on public health policy issues.

During law school at The George Washington University, Professor Hughes served as legal research assistant to Professor Sara Rosenbaum, renowned health law scholar and Founding Chair of the Department of Health Policy. His studies at law school included an intensive independent study of the United States health insurance regulatory framework. In addition to his Juris Doctor, Professor Hughes holds a Master of Public Health degree from the University of Arkansas for Medical Sciences. He is a member of the District of Columbia Bar and the national Delta Omega Honorary Society in Public Health.

Professor Hughes is a recognized expert in vaccine policy and state health policy and governance. His diverse professional accomplishments include:

Serves as a trusted advisor to the world's largest vaccine manufacturers on a range of policy and business strategy matters
Advised the State of Maryland’s Medicaid program on the design of a dual eligible coverage model and represented the program in negotiations with the Center for Medicare and Medicaid Innovation
Co-led a multi-disciplinary consultant team to establish a single-payer healthcare system in the British Virgin Islands, including advising the national government on the creation of its National Health Insurance (NHI) program and its governance and organizational structure; led the development of NHI program policies and business rules, provider credentialing and contracting processes; developed the structure of the relationship between the NHI and Health Services Authority; evaluated and negotiated with claims software vendors and international network providers; and advised NHI leadership on critical launch activities
Contributed to successful expansion of provider scope of practice laws to increase vaccine access in multiple large states
Advised many state boards and government agencies on health policy issues
As a member of the Arkansas State Board of Health, initiated public discourse regarding a school-entry requirement for the the human papillomavirus vaccine

Expertise

Expertise:

Access to Health Care

Federal and State Legislation, Laws and Policies

Health Law

Health Policy

Health Professions

Health Insurance

Health Reform

Immunization Law and Policy

State Health Issues

Health Quality

Managed Care

Medicaid and SCHIP

Medicare

Education:

Juris Doctor, The George Washington University Law School

Master of Public Health, University of Arkansas for Medical Sciences

Bachelor of Science, Arkansas State University

Teaching:

State Health Policy (PUBH 6356), Fall 2015

Health Law & Policy (HSML 6267) Spring, Summer (2 sections) and Fall 2016

Residency Fellowship Rotation in Health Policy, semi-annually, Fall 2015 to Present

State Health Policy(PUBH 3199), Fall 2017, Fall 2018

Reproductive Policy & Politics (PUBH 3199), course currently under development

Community Service:

Advisory Committees

State Boards of Health Working Group (2011-2013), National Association of Local Boards of Health

Executive Committee, State Health Research & Policy Interest Group (2009-2010), AcademyHealth

Planning Committee, Public Health Law & Policy Conference (2009-2010)

Other Professional & Volunteer Involvement

Langley Elementary School, “Breakfast with a Legend” Program, Spring 2016

D.C. Bar Pro Bono Center, Volunteer Attorney (2014-Present)

American Journal of Public Health, Peer-Reviewer (2007-Present)

American Cancer Society, Cancer Action Network, Leadership Advocate (2007-2009)

Publications

Publications:

Refereed Journal Articles

Hughes, RH, With a Worthless Services Hammer, Everything Looks Like a Nail: Litigating Quality of Care Under the False Claims Act, J. Legal Med, 37:01-02:65-104 (2017).

Hughes, RH, et al., State Boards of Health: Governance and Politics, J. Law Med Ethics, Vol. 39, Issue Supp. s1, pp. 37–41 (2011).

Works in Progress

Linking Vaccines and Quality: Improving Immunization Rates in the Era of Value-Based Payment

Book Chapters

Hughes, RH, Atlas, RF, Paying for Person-Centered Care: the Role of Health Care Payment and Quality Policy. In Donald Zimmerman, et al. ed., Person-Focused Health Care Management: A Foundational Guide for Health Care Managers. 2016, Springer Publishing.

Hughes, RH, Legal and Ethical Issues in Person-Centered Care. In Donald Zimmerman, et al. ed., Person-Focused Health Care Management: A Foundational Guide for Health Care Managers. 2016, Springer Publishing.

Yeung, LR, Kim, B, Hughes RH, The Road to Value-Based Payments: Where We’ve Been and Where We’re Going: Considerations for Provider Engagement in Value-Based Purchasing Models. In John Steiner, ed., Health Law and Compliance Update, 2017 Ed. 2016, Aspen.

Refereed Presentations

Sobel, E, Hughes R, Immunization and “Repeal and Replace”: How Congressional Efforts to Undo the Affordable Care Act Would Have Impacted Immunization Coverage and Access,National Immunization Conference, Atlanta, GA (2018)

Sobel, E, Hughes R, State-Level Policy Strategies Needed to Improve Adult Immunization Uptake, National Immunization Conference, Atlanta, GA (2018)

Hughes, R, Liow, C, Understanding the Current Role of Immunization Measures in Quality-Based Policies, National Immunization Conference, Atlanta, GA (2018)

Hughes, RH, Albader, B, Orlino, A. State Boards of Health: A Closer Look at Roles and Relationships. National Association of Local Boards of Health, Omaha, NE (2010).

Hughes, RH, Wasserman, T, Moscetti, C, Jarris, P. Role of State Boards of Health in the Public Health System, Public Health Systems & Services Research Keeneland Conference, Lexington, KY (2010).

Hughes, RH, Sutaria, S. State Emergency Powers in Imminent Threat Scenarios: Comparative Analysis, Practice Implications & Policy Considerations, Public Health Emergency Preparedness Summit, Atlanta, GA (2010).

Hughes, RH, Ryan, KW, Hogan, RD. Higher Education Pre-Matriculation Immunization Requirements: A Comprehensive Assessment and Policy/Program Considerations, American Public Health Association 137th Annual Meeting, Philadelphia, PA (2009).

Ryan, KW, Hughes, RH. Pre-matriculation requirements for colleges and universities: Is it time for all states to mandate as a condition of entry?, American Public Health Association 137th Annual Meeting, Philadelphia, PA (2009).

Non-Refereed Reports & Op-Eds

Hughes RH, et al. Exploring Third Party Billing for Vaccines by State Public Health Entities. Association of State and Territorial Health Officials (Mar. 2010).

Acknowledgement: Partnering for the Public’s Health: The Role of Public Health Institutes as Fiscal Agents and Intermediaries. National Network of Public Health Institutes. (Nov. 2009).

Sellers K, Hughes RH, Pearsol J, Elliot PI. State Perspectives on the Use of Fiscal Intermediaries. Association of State and Territorial Health Officials. Submitted to Thomas Frieden, Director, Centers for Disease Control and Prevention (Nov. 2009).

Hughes RH. Combine Both Plans for Health Care Reform [Special Guest Column]. Arkansas Democrat Gazette, p. 7B (Oct 13, 2008).

Hughes RH. Prevention is Priority of Vaccine Program [Special Guest Column]. Arkansas Democrat Gazette, p. 9B (Mar. 15, 2007).

Non-Refereed Presentations & Speeches

Webinar, Barriers to Access: Reforming Medicare Coverage of Vaccines, Avalere Health, Washington, D.C. (2018).

Co-presenter, Trends in Utilization Management: Prior Authorization and Step Therapy Policies in Select States, Sanofi Advocacy Council, Washington, D.C. (2018).

Webinar, Increasing Adult Immunization Rates in the U.S. through Data and Quality: A Roadmap, Avalere Health, Washington, D.C. (2017).

Panelist, A Balancing Act: The Intersection of Industry and Policy, Duke University, MBA Health Care Conference, Durham, NC (2016).

Co-facilitator, Vaccines and Quality Roundtable, Avalere Health & GlaxoSmithKline, Washington, D.C. (2016).

Panelist, Careers in Health Law, University of Virginia Law School, Charlottesville, VA (2016).

Featured Assembly Speaker, Manila Middle School, Manila, AR (2016).

Webinar, Alignment and Simplification of Quality Measures Across Markets, Epstein Becker Green, Washington, D.C. (2016).

Panelist, State Board of Health Roundtable, National Association of Local Boards of Health, Atlanta, GA (2012).

Planning committee member, session organizer, Regulatory Approaches to Policymaking, National Public Health Law & Policy Conference, Atlanta, GA (2010).

Making the Workforce Case to State Legislators, State Public Health Workforce Summit, Atlanta, GA (2010).

Luncheon speaker, State Health Officials: Advancing Injury Prevention Policy, “Addressing a Winnable Battle”: Transportation and Public Health Officials Join Forces to Decrease Preventable Injuries and Death Due to Motor Vehicle Crashes, Arlington, VA (2010).

Organizer/facilitator, State Health Policy ‘Swap Shop,’ Association of State and Territorial Health Officials Annual Meeting, Vienna, VA (2009).

Panelist, Emory University Rollins School of Public Health’s 4th Annual Washington, DC Networking and Study Tour for Public Health Graduate Students, Washington, D.C. (2009)

Co-facilitator, Strengthening the Health Care Safety Net Workforce Through Interagency Cooperation, Planning and Policy, National Conference of State Legislatures Annual Legislative Summit, Philadelphia, PA (2009).