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Description
Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • U.S. Court of Appeals Considered my expert opinion, vacating and remanding sentencing in a criminal Medicare fraud case • Three U.S. DOJ retentions, $155 million settlement, an expert in anti-trust / FTC. Intellectual property; complex fraud coding, fraud damages expert • Healthcare IT patents intellectual property Technical Expert, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal chord stimulators, blocks, p-stim, anesthesia, Nephrology, MIPS, MACRA, Computer Assisted Coding, Physician Fee Schedule, Medicare Administrative Contractors, Medicaid expansion, Qualified Health plans - Labor Law, uninsured patient discounts, California Law confidential information, Benefits Administration, Fraud under Qui Tam False Claims Act. Eligibility, coverage determinations; physical therapy, HL7, ICD-10, computer-assisted coding, Knox-Keene Act, Stark Law, Sunshine Act, Insurance Bad Faith. • Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical
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