Medicare Medicaid Fraud & Healthcare Billing Compliance Expert Witness

This expert has extensive experience providing testimony and consulting on medical billing, coding, Medicare and Medicaid fraud, and damages calculation. Experienced in federal and state courts, including appeals and Daubert hearings, with a background that includes electronic health records, healthcare IT, and compliance with privacy and security regulations such as HIPAA and the HITECH Act. Has worked with government agencies including the U.S. Department of Justice on large-scale fraud investigations, and is skilled in use of eDiscovery tools for document review. Services include expert reports, consulting, testimony, record review, and litigation strategy on complex healthcare regulations, billing disputes, and reimbursement analyses across multiple healthcare sectors and payer systems.

Professional Affiliations:

Health Information Management Systems Society (HIMSS)
Workgroup for Electronic Data Interchange (WEDI)
American Academy of Professional Coders (AAPC)
American Health Information Management Association (AHIMA)
Radiology Business Management Association (RBMA)
California State Bar Association
American Academy of Pain Medicine
Medical Group Management Association (MGMA)

Education:

Biomedical Informatics (Harvard Medical School, Stanford Medical School)
Bachelor of Science, Business Administration (University of Southern California)

Areas of expertise:

Addiction Medicine
Analytical Testing Labs
Community Mental Health
Group Home Health Care
Economics
HIPAA
Hospital & Medical Ethics
Hospital Administration
Hospital Security
Information Technology
Intellectual Property
Life Care Planning
Medical Billing
Medical Fraud
Orthopedic Surgery
Patents
Pathology
Software

Case Study:

Medicare
Medicaid
Medicare Fraud
Medical Billing Disputes
Healthcare IT Litigation
HIPAA Privacy and Security Issues
False Claims Act
Ambulance Billing and Fraud
Life Care Planning Rebuttals
Reimbursement and Coding Audits
EMR/EHR Forensic Auditing

Certifications:

Lean Six Sigma and Process Improvement (Villanova University)
Leadership Strategies (Wharton School, University of Pennsylvania)
Clinical Documentation and Medical Coding Training (Multiple specialties, 2013)
HIPAA Privacy and Security Instructor
HCC Coding and Clinical Documentation for Value Based Care
DRG Calculations and IPPS/OPPS Payment Systems

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