Representative Matters

  • Developed a defensible coding/extrapolation strategy that reduced a $3.6 million recoupment to $86,000
  • Served as a federal monitor team lead for 18 months for a device company’s deferred prosecution agreement
  • Served as a monitor for an Office of Civil Rights’ HIPAA Corrective Action Plan with a large academic medical center (for three years)
  • Conducted compliance diligence as part of a $3.9 billion acquisition
  • Handled compliance preparation for a multistate hospice
  • Developed and implemented a corrective action plan for an academic medical center in a 340B audit that was conducted by the Health Resource & Services Administration and included the manufacturer repayment process
  • Developed a corrective action plan for a hospital with alleged violations of the Emergency Medical Transport and Active Labor Act (EMTALA), and imposed the “immediate jeopardy” process by the Centers for Medicare & Medicaid Services
  • Managed a medical practice with clinical- and academic-based physicians, which included serving as a billing compliance committee member for a 400+ physician faculty medical group and handling fraud/abuse and privacy issues and compliance plan development, implementation, and monitoring
  • Developed a new medical faculty department specifically targeted as the primary care entrance for a 110,000-square-foot multi-specialty center, including handling departmental integration and centralized organization of staffing models, competency models, budgets, billing compliance, protocols (clinical and administrative), procedures, governance, patient flow, cost-benefit analyses, and pro formas
  • Oversaw human resource development, departmental policy and maintenance procedures, CLIA certification, and compliance with OSHA and Accreditation Association for Ambulatory Health Care (AAAHC) regulations