What We Do
RegQuest is an online, subscription-based research tool that provides its subscribers with easy and immediate access to state specific regulations, rules and statutes to ensure superior compliance with each states’ unique and complex Health and Workers’ Compensation Utilization Management, External Review and Grievance procedures.
RegQuest is the essential guide for health care professionals, compliance staff, benefit administrators, consumers, providers, government officials and other stakeholders who require a comprehensive understanding of medical management regulations. All modules are vetted by a team of legal experts and state regulators, and are updated regularly to ensure all information is current and accurate.
Jessica Grillo, Esquire
As Executive Director of RegQuest, Ms. Grillo is responsible for the development of site content, blogs, and statutory and regulatory updates. She also provides in-house legal support and oversees all policy development.
Prior to joining RegQuest, Ms. Grillo worked in private practice, litigating civil and domestic cases throughout Maryland and Washington D.C. She is an alumnus of both Barry University School of Law (Juris Doctorate) and Penn State University (Bachelor of Science).
BOARD OF DIRECTORS
Garry Carneal, JD, MA
Garry Carneal is a leading expert in health care having researched, written and published extensively on quality, medical management, information technology and regulatory trends. He has established a track record helping trade associations, accreditation organizations, and other health-related businesses scale nationally. Throughout his career, Mr. Carneal has brought to market over 20 accreditation programs that have been recognized by 45 states and three federal agencies.
Mr. Carneal is both the Founder and CEO of Schooner Strategies, a health care-focused consulting firm and co-founder of RegQuest. He serves as the Senior Policy Advisor to The Kennedy Forum and is the Advisory Board Chair for RadSite, which provides accreditation programs in advanced diagnostic imaging. Mr. Carneal also serves on several non-profit boards including the Population Health Impact Institute.
Mr. Carneal received an undergraduate degree from Washington & Lee University, a master’s degree from Yale University and a law degree from the University of Virginia.
An accomplished healthcare executive, Michael Gomes has more than 35 years of experience in sales, business development, healthcare management and Government Relations. Prior to his appointment as CHQI’s Chief Executive Officer, he was a founding executive of BenefitMall and served as President of its Benefits Division. During his nearly 20-year tenure, BenefitMall grew to become the nation’s largest Employee Benefits General Agency.
Mr. Gomes has also held senior executive roles with a number of other leading companies including Prudential HealthCare, Empire Blue Cross and Blue Shield (now Anthem), Horizon Blue Cross and Blue Shield and the New Jersey Department of Insurance. He is an industry “thought leader” and a frequent speaker on topics related to healthcare reform and workforce solutions for small to medium sized businesses.
Mr. Gomes is a graduate of Rutgers University with a Bachelor of Arts degree in economics and holds an MBA in quantitative analysis from Fairleigh Dickinson University.
Ed Bolton is the Founder and CEO of Nexus Medical, a national clinical review organization that has received multiple accreditations while dedicating the highest quality of service to clients across the nation.
Mr. Bolton’s commitment and medical experience spans more than 25 years with emphasis on business center influence, group health, workers’ compensation, auto liability, and disability.
Mr. Bolton is an active Board Member in a number of civic, non-profit and for-profit organizations, to include President of the Executive Committee for the National Association of Independent Review Organizations (NAIRO), member of Workers’ Compensation Research Institute (WCRI) Texas Advisory Board, Vice Chairman for the Greater New Braunfels Economic Development Foundation, and Dean’s Advisory Board for Wayland Baptist University and McCoy College of Business Administration, Texas State University.
Mr. Bolton’s professional accomplishments include the completion of a Master’s Degree from the University of Nebraska with residency training in Occupational Medicine as well as authoring of a number of literary works related to disease management, workers compensation injury, PPACA, as well as medical briefs on certain conditions such as low back pain.
Gilbert (Gib) Smith, Esq.
Gib Smith is an executive with more than 25 years of extensive experience and expertise in project, program, and team management in both the healthcare professional and non-profit environments. As the President of GPS Consulting Services, Mr. Smith provides corporate counsel, compliance services, and business development services for a variety of clients including firms that specialize in government contracting, accredited independent review organizations (IROs), Health Utilization Management (HUM) organizations, and related healthcare entities.
As the Executive Director of the National Association of Independent Review Organizations (NAIRO), Mr. Smith has helped to shape the health care industry related to the provision of independent medical review (IMR) and HUM. In this role, Mr. Smith leads this 30-member association, which is dedicated to the protecting the integrity of the independent review process for all stakeholders.
Mr. Smith received an undergraduate degree from James Madison University and received a law degree from George Mason University.
Thomas Naughton is responsible for the management and performance of MAXIMUS Federal’s largest book of business, which includes benefit appeals and independent medical review services. His client base includes more than 54 federal and state agencies. Mr. Naughton also manages large-scale federal customer call and processing centers.Mr. Naughton has extensive experience in health care reimbursement, Medicare, Medicaid, workers’ compensation, state health care law, quality oversight, peer review and all forms of benefit disputes and dispute resolution programs. He has testified before the United States Senate Finance Committee on Medicare appeal reform and has served as a subject matter expert in the development and implementation of an independent medical review and provider payment dispute resolution program for the California Workers’ Compensation system.Mr. Naughton earned his B.A. degree in English and political science from the State University of New York at Buffalo. He holds a Master of Laws degree from Loyola University Chicago School of Law and a Juris Doctorate degree from the State University of New York at Buffalo School of Law. He is also a Board Member of the MAXIMUS Foundation.