Healthcare Management Expert Witnesses
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Healthcare Management Expert Witness - Representative Bios
Please Note: All Cahn Litigation expert witness searches are customized to attorneys' precise specifications and preferences. Attorneys are encouraged to discuss search parameters with a Cahn search specialist.
The below expert witness bios represent a small fraction of those Healthcare Management experts known by Cahn Litigation Services. These bios are provided to give lawyers a sense of the Healthcare Management landscape.
Expert Witness #234755
This expert is a consultant in physician pro fee medical coding, billing and compliance. This expert is President & CEO of a firm where this expert performs audits for practices in many specialties, including Urology. This expert has spent an entire career in the medical field, and has consulted for many organizations including the American Medical Association (AMA), and the Center for Medicare & Medicaid Services (CMS).
This expert is a seasoned expert witness for Healthcare Attorneys in need of coding, reimbursement or process review, audit, opinion and testimony. This expert has testified in federal court for physicians accused of criminal fraud and has defended physicians in civil cases, which involved writing reports and giving depositions.
This expert is on the Editorial Advisory Boards of multiple specialty newsletters, and is a frequent speaker for many organizations including the American Academy of Professional Coders (AAPC), Medical Group Management Organization (MGMA), AudioEducator, CodingConferences.com, The Coding Institute, and Ingenix. Current certifications include: Certified Professional Coder (CPC) - AAPC; Certified Professional Coder for Hospital Outpatient Services (COC) - AAPC; Certified Professional Coder for Third Party Payers (CPC-P) - AAPC; Certified Professional Coder Instructor (CPC-I) - AAPC; and Certified Professional Compliance Officer (CPCO) - AAPC. This expert holds a BS in Industrial Engineering and an MBA.
Start Healthcare Management Expert SearchExpert Witness #250310
This expert is a Medicaid Fraud, medical billing, and hospitals best practices expert. This expert is the managing partner of a healthcare compliance and process consultancy which focuses on healthcare regulations, and medical coding and billing. This expert has served as an advisor to healthcare providers on hospital and practice management, and has thorough understanding of treatment plans, and their importance in the admission process. This expert was selected as an expert for a landmark Federal Trade Commission case regarding healthcare data, regulations and economics. This expert has also served as an expert witness for the United States Department of Justice in a federal investigation into medical data, Health IT / E.H.R. stimulus funds and False Claims Act. This expert has also been involved in Medicare and Medicaid fraud matters. This expert has dozens of publications and is a frequent lecturer at industry conferences
Start Healthcare Management Expert SearchExpert Witness #250672
This expert has many years of experience in healthcare and in implementing information systems and technologies for process change and value creation. This expert provides consulting on healthcare software development, healthcare product positioning, Healthcare Transformation and Strategic Planning, and Process/Technology Improvement. Through a highly successful consultancy, this expert has provided consulting for many healthcare organizations. This expert has consulted with many companies, leading to many award winning software, technology and product development projects. This expert was the Executive Vice President of a core administration systems software provider to the Health Plan Market where this expert directed new product development. This expert also has served as Associate Professor of Medical Informatics and Director of eHealth Initiatives at a University's School of Health Systems. This expert was the co-founder and Executive Director for an EMR services company. This expert was Vice President of an international healthcare consulting company; and a founding member and CEO of an eHealth Application Solution Provider (ASP). This expert co- founded and was the Chief Technology Officer of an enterprise managed care solutions provider for healthcare networks. This expert was involved with the Department of Health and Human Services in the formulation of the HIPAA Rules. This expert has been intimately involved with the security, privacy, transaction and code set rules. This expert is a past member of the HL7, ANSI X.12, and ActiveX for Healthcare standards groups.
Start Healthcare Management Expert SearchExpert Witness #250687
This expert is a senior expert in the use of IT. This expert's expertise includes providing expert witness support. This expert has been involved in IT for many years and has owned and directed a healthcare IT consulting firm. This expert has a proven track record of dealing with all aspects healthcare IT including IT operations, IT planning, system selection, system implementation, IT contract negotiation, and project management. This expert holds a Master of Science in Administration, CPA, and CCP (Certified Computer Professional). This expert has developed and taught courses in the Management of Healthcare IT. This expert's course is required for the MBA (specialization of Master's in Health Administration) and is taught for students in the University's Health Science Center. This expert has extensive prior expert witness experience including depositions, trials, mediation and arbitrations.
Start Healthcare Management Expert SearchExpert Witness #262476
This expert is a nationally recognized subject matter expert in healthcare information management, quality management, and compliance. This expert has conducted healthcare fraud and abuse coding compliance defense reviews and clinical documentation audits for healthcare organizations. This expert has worked as a compliance consultant and conducted medically necessity reviews for healthcare organizations and law, having worked on Urology specifically.
This expert is a national speaker, author and adjunct professor on the topics of health information operations, information governance, e-discovery and healthcare compliance. This expert is an active member of the Health Level Seven (HL-7) Working Group, responsible for the review and development of the Records Management and Evidentiary Support (RM-ES) profile for the design and development of the functional profile for electronic health record systems. This expert has also been an active member and contributor in AHIMA task forces and working groups related to information governance and the functional design and profile of electronic health record (EHR) systems. This expert is a member of The Sedona Conference Working Group on Best Practices for Electronic Document Retention and Production, the American Medical Informatics Association (AMIA), the Health Information Management Systems Society (HIMSS), the American Society for Healthcare. This expert holds an MBA, a Master of Jurisprudence degree in Health Law and Policy, and Post Baccalaureate in Clinical Informatics. This expert has provided expert witness services to both plaintiff and defense counsel.
Start Healthcare Management Expert SearchExpert Witness #262528
This expert has extensive experience in auditing, coding, and billing for many practice areas, including urology, oncology, hematology, internal medicine, endocrinology, neurology, hospital medicine, critical care and other practice areas. This expert is a nationally known speaker and educator with credentials from the two most recognized organizations in the field of medical coding training and certification: the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). In addition to being a Certified Professional Coder, this expert is also a Certified Risk Adjustment Coder, a Certified Coding Specialist, and an approved Coding Trainer for AHIMA. This expert has been published in the national publication AAPC Healthcare Business Monthly Magazine and is a frequent expert contributor to industry publications.
This expert founded a national consulting firm specializing in coding and compliance advisory solutions. This expert has developed and designed instructor-led and web-based training in medical coding, billing, and compliance. This expert has served as an expert witness and has worked on many litigation matters.
Start Healthcare Management Expert SearchExpert Witness #125909
This medical device engineering expert holds a PhD and has over 35 years of hands-on healthcare technology life-cycle experience supporting forensic engineering investigations and litigation, intellectual property validation, healthcare technology management operations, regulatory compliance, including FDA regulations, and global innovation involving medical devices. This expert provides medical device consulting and helps educate attorneys and courts on healthcare technology-related matters, including complex regulatory requirements, labeling compliance, design and manufacturing, intellectual property processes, device-owner roles and maintenance obligations, interoperability, networking, and device risk management programs.
This expert can investigate product life stages from design considerations, medical device development, and manufacturing quality control through post-market complaint management and fulfillment of owner responsibilities. This expert provides clear explanations of causation for judges and juries.
This expert has experience in intellectual property litigation strategy, where product evolution and the strength of a competitor's patent can affect claim validity. This expert has performed novelty searches to help determine the state of patent-claim novelty and develop evidence relevant to alleged infringement. Knowledge of prior art from the perspective of a "person skilled in the art" is additional critical information this expert can address in matters involving medical products.
Start Healthcare Management Expert SearchExpert Witness #278440
This healthcare contracts and Medicare billing expert has diverse experience in the healthcare industry, including senior reimbursement consulting, healthcare compliance leadership, billing compliance operations, and leadership of a compliance firm providing medical coding, litigation support, and compliance solutions to healthcare providers.
This expert completed a Bachelor of Science in Health Planning & Administration (HPA), studying Health/Health Care Administration/Management. This expert has obtained several certifications, including Certified Medical Cost Projection Specialist (CMCPS), Certified Professional Compliance Officer (CPCO) from a professional coding organization, and Certified Professional Coder (CPC) from a professional medical coding association.
Start Healthcare Management Expert SearchExpert Witness #281183
This lost earnings/damages expert leads a healthcare consulting firm focused on valuation and financial analysis for hospitals, physician practices, and other healthcare enterprises. This expert has served a diverse range of healthcare industry and medical professional clients nationwide, including physician solo and group private practices across medical specialties, subspecialties, and allied health professions; hospitals and health systems, both tax-exempt and for-profit; managed care organizations; ancillary service providers; outpatient services; management services organizations; government agencies; public health and safety agencies; other related healthcare enterprises and agencies; and advisory professionals.
This expert provides a wide range of technical assistance to legal counsel through litigation support services focused solely on the healthcare industry, including lost or enhanced earnings capacity, antitrust issues, provider relationships, healthcare valuation of enterprises, assets, and services, commercial damages, merger, acquisition, or divestiture transactions, managed care issues, healthcare industry research, shareholder disputes, economic and utilization demand forecasting, bankruptcy, discrimination, certificate of need feasibility analyses, and fraud and abuse issues. This expert has assisted in cases in Federal District Courts, State Courts, Tax Court, Bankruptcy Court, and arbitrations, involving complex economic, legal, financial, valuation, and related issues across a broad spectrum of provider entities in the healthcare industry.
Start Healthcare Management Expert SearchExpert Witness #282235
This construction management/contractor expert is a retired senior-level construction management professional with over 45 years of experience throughout the U.S. on large-scale projects, including high-rise office, four- and five-star hotels, luxury residential and mixed-use, healthcare replacement and renovation, governmental, educational, investment banking, trading floor, data center, houses of worship, biopharmaceutical, light manufacturing, and high-end retail projects.
This expert has led project teams on large, complex urban projects through preconstruction and construction phases, commissioning, turnover, and project closeout. This expert also has experience building apartments, condominiums, hotels, and schools and previously served in construction project management roles.
This expert is experienced in expert witness and litigation consulting work.
Start Healthcare Management Expert SearchExpert Witness #284858
This home health care administration expert holds a Bachelor of Science Nursing, Masters in Public Administration, and Doctorate in Nursing Practice from prestigious universities, with substantial experience in nursing administration and healthcare operations.
This expert has held senior executive roles overseeing patient care services and nursing leadership in large acute care academic hospitals, served as a surveyor for a rehabilitation accreditation commission, prepared organizations for accreditation and regulatory surveys, and worked as a lecturer and educator in academia.
This expert has presented internationally and nationally on topics including pressure injury management, leadership, management of operational failures, regulatory compliance, and quality. Integrating clinical knowledge and technical expertise enables this expert to provide critical thinking as an Expert Witness. This expert has been deposed and cross-examined, with a focus on nursing and healthcare organization standards of care.
Start Healthcare Management Expert SearchExpert Witness #285019
This urological medical billing and coding expert is an executive healthcare consultant with over 30 years of experience working with healthcare facilities, payers, physicians, and staff, specializing in revenue cycle integrity management, Recovery Audit Program appeals, CDI audits, CDM reviews, operational assessments, multispecialty medical record reviews related to documentation and coding, compliance plan evaluations, forensic auditing, litigation support, and expert testimony.
The majority of this expert's work has involved laboratory testing in some capacity, with urological testing being one of the most common tests performed. In addition to coding and billing principles, appropriate coverage determinations or payer guidelines must be applied when auditing urological tests. This expert also has direct experience with urological testing, including work with a federal healthcare agency's negotiated rulemaking committee for national laboratory coverage policies related to gastrointestinal and renal systems.
Start Healthcare Management Expert SearchExpert Witness #289366
This family medicine consulting expert is currently the principal of a healthcare consulting practice after a long career as a pediatric primary care physician and medical school professor. The consulting practice provides management leadership, organizational and operational assessment, corrective action plan development and implementation, contract negotiation, and litigation support services.
Start Healthcare Management Expert SearchExpert Witness #293285
This electronic medical records expert is a registered nurse who holds an M.Sc. in Health Informatics, a BSN, and a CSA credential, with over 15 years of healthcare informatics and technology experience. This expert's clinical and informatics background supports review of records for continuity of care.
This expert has worked as a consulting witness on over 40 cases related to electronic medical records. This expert has worked in healthcare and healthcare informatics for many years, including clinical settings such as intensive care, rapid response, hospice, and home care. In healthcare informatics, this expert has held roles including RN, system analyst, project management, and leadership while working with multiple electronic medical record systems.
This expert reviews cases from multiple points of view with attention to detail and finding answers. This expert can educate legal teams on healthcare, standards of care, electronic medical records, and healthcare information technology, while offering questions informed by experience. This expert can also organize and summarize electronic medical records as requested.
Start Healthcare Management Expert SearchExpert Witness #296793
This health claims sampling expert holds a B.Sc. in Accounting, is a Certified Public Accountant (CPA), holds the FAAMA credential, and serves in senior executive and principal healthcare consulting roles specializing in healthcare finance, Medicare, regulatory compliance, pricing, and managed care and insurance payment and contracting.
This expert has provided expert witness testimony in court and administrative proceedings and has presented testimony to state healthcare rate-setting authorities, federal oversight bodies, and federal healthcare agencies on issues including healthcare facility rate setting, Tri-Care funding and reimbursement, air ambulance prospective fee schedules, and physician fee schedules for MOHS dermatology surgeons. This expert also served for over 10 years as a national regulatory practice leader at a major professional services firm recognized for healthcare professional services.
This expert has evaluated claims handling and payment procedures in a prompt-pay dispute involving member hospitals, identifying process improvements intended to expedite processing and reduce denials. In another healthcare compensation dispute involving primary care physician partners and allegations of upcoding, this expert evaluated a statistical sample of claims, identified sampling flaws and coding bias, and provided deposition testimony on those issues.
This expert has managed installation and maintenance projects for a decision-support claims management system designed to track expected payment of patient claims based on contract terms with payors across dozens of hospitals.
This expert has analyzed statistical sampling issues in healthcare post-payment audits, including audits using samples over multiyear periods to disallow claims and seek multimillion-dollar recoupments. In one matter, this expert's rebuttal of the statistical sampling methodology supported placing recoupment on hold while the merits of alleged errors were resolved, and the redetermination appeal was successful.
This expert has also analyzed Medicare time-record audits involving clinical and non-clinical staff records maintained in short time increments. The analysis showed that auditors had effectively examined each time increment within sampled time records, substantially increasing the effective sample size and reducing the calculated error rate to below 1 percent. Based on that analysis, no audit adjustment was appropriate.
This expert has conducted primary research and survey work in healthcare reimbursement disputes, including surveys of thousands of skilled nursing facilities addressing cost-reporting and reclassification issues. The survey evidence was used in an administrative appeal to address a federal healthcare agency's position on reporting practices.
This expert is an experienced expert witness and litigation consultant whose experience includes thousands of PRRB appeals, including hearings, mediations, telephonic hearings, and on-the-record hearings; hundreds of Administrative Law Judge hearings for workers' compensation appeals; U.S. District Court and appellate court hearings involving civil litigation and government investigations; and criminal investigations involving expert witness testimony and interviews with oversight investigators and U.S. Attorneys.
Start Healthcare Management Expert SearchExpert Witness #299571
This Medicare policy and Anti-Kickback expert team includes experts with CHC, CPC, MPA, MD, and JD credentials and brings deep expertise across regulatory enforcement, government oversight, clinical review, and complex disputes.
One expert has over 25 years of experience in healthcare operations, revenue cycle management, compliance, and forensic analysis. This expert has served as an expert in False Claims Act matters, payment integrity disputes, billing and coding assessments, and internal investigations across hospitals, physician groups, academic medical centers, and national health systems.
Another expert is a former Inspector General at a federal health oversight agency, where the role involved oversight of a large workforce and audits and investigations covering trillions of dollars in annual federal healthcare spending. This expert's insight into government expectations, enforcement priorities, program integrity, Medicare and Medicaid compliance, and oversight protocols strengthens the team's ability to support litigation and regulatory matters with significant perspective.
A third expert is a former Chief Medical Officer at a federal health oversight office, where this expert spent more than two decades leading clinical and regulatory oversight for federal healthcare programs. This expert provides expert clinical review, medical necessity evaluation, coverage analysis, peer review, and medical record assessment, and brings significant experience with government agencies on matters involving patient care standards, quality, and clinical compliance.
Start Healthcare Management Expert SearchExpert Witness #302521
This medical privacy expert is an MD, MBA, and FACP, and is a licensed physician executive with experience in healthcare administration.
This expert has worked in the health insurance industry with increasing areas of responsibility regarding leadership and patient care system management. This expert has also served as an examiner for a prominent national healthcare quality award and a national healthcare quality-assurance accreditation organization, which promote standards for accreditation of healthcare organizations with respect to patient care quality, safety, and HIPAA compliance.
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