Healthcare Fraud, Billing Compliance & Medical Coding Expert Witness

This expert witness has extensive experience providing specialized opinions and testimony in medical billing, coding, healthcare fraud, and compliance, particularly related to Medicare, Medicaid, and commercial insurance programs. This includes authoring expert reports, consulting on damages calculations, and providing forensic audits of electronic health records. The expert has testified in federal and state courts, participated in complex investigations involving billions in fraud, and advised on regulatory compliance and healthcare IT standards. Expertise also includes HIPAA privacy and security, Affordable Care Act policies, risk adjustment, and the economics of healthcare reimbursements. The professional engages regularly with legal teams to provide litigation support, expert testimony, and strategic advice across healthcare sectors including hospital systems, pharmaceutical and medical device industries.

Professional Affiliations:

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

Education:

Harvard Medical School Bioethics
Stanford Medical School Biomedical Informatics
Massachusetts Institute of Technology Blockchain and Distributed Secure Healthcare Applications
University of Southern California Bachelor of Science Business Administration

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 Fraud
Medicaid Compliance
Healthcare Billing Disputes
Medical Coding Disputes
Healthcare IT Patent Infringement Cases
Medicare Administrative Contractors Disputes
False Claims Act Qui Tam Provisions
Life Care Plan Rebuttals
HIPAA Privacy and Security Violations
Affordable Care Act Coverage Disputes

Certifications:

Lean Six Sigma and Process Improvement
ICD-9, ICD-10 and CPT Clinical Documentation and Medical Coding Training
HCC Coding and Clinical Documentation for Value Based Care Risk Adjustment
DRG Calculations and ICD-10, IPPS and OPPS Payment Systems
Instructor HIPAA Privacy and Security and HITECH Act Electronic Health Records