Mr. James Bailey

Center for Medicare & Medicaid Services (CMS)


James Bailey is the Medicare Pharmaceutical and Technology Ombudsman within the Centers for Medicare & Medicaid Services (CMS), and serves as a lead for a small team of Medicare innovation liaisons (i.e. navigators established to assist medical technology innovators with engaging CMS for coding, payment, and coverage matters/concerns and information requests). He has experience in addressing concerns and questions from pharmaceutical, biotechnology, medical device, diagnostic product manufacturers and other stakeholders regarding Medicare coverage, coding, and payment for products already covered or for which coverage is being sought.  Prior to taking on his current role, James served as the Deputy Director of the Medicare Ombudsman Group within CMS’ Offices of Hearings and Inquiries, where he provided leadership and guidance for activities to establish and support the Medicare Beneficiary Ombudsman and DMEPOS Competitive Acquisition Ombudsman functions within CMS.  James has a healthcare background with over 20 years of combined military and federal civil service, which includes patient care and healthcare administration. He has held various positions in CMS customer service components since 2002.  He currently works closely with colleagues in the Technology, Coding and Pricing Group and other CMS Groups responsible for various aspects of medical technology policy and reimbursement functions.