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View our Expert Witness DirectoryThis expert is a board certified internal medicine doctor who has been working as an attending physician in a nursing home for over 30 years. He has extensive experience in dealing with patients who are at higher risk for falls.
Attending Physician, 2 Major Geriatric Health Care Groups
Doctor of Medicine (MD), Northwestern University Medical School
Maryland
30 years of employment in a community hospital advancing to the executive level as the organizations Chief Nursing Officer. Lead the organization to successful state and JCAHO surveys, knowledge of patient care and medical staff standards. Authored organizational policies and procedures in accordance with best practices. Oversight of 500 FTEs to include nursing and allied support staff for clinical care departments. Provided oversight administration for a long term nursing facility associated with the organization. Participated in CMS surveys. Actively worked with risk management and quality Improvement processes. Knowledge of HR policies and practices to include implementation and enforcement. Developed and implemented the entire operational process for a start up free medical community.
Nurse Administrator, An outpatient community clinic in GA
Bachelor of Science (BS), DeVry University
Sharpsburg,
Georgia
This expert is an extremely well-qualified internist with additional experience and interest in geriatrics, palliative medicine, and hospice care. She has published more 28 peer-reviewed primary publications, review articles, invited articles, abstracts and book chapters. This expert has also traveled, giving numerous presentations on geriatrics, palliative medicine and hospice care. She currently holds a physician position at one of the finest VA institutions in the country, University, and is medical director for a program of all inclusive care for elderly
Associate Professor, A major medical school in NV
Doctor of Medicine (MD), Drexel University College of Medicine
San Diego,
California
This expert has been an administrator in every kind of long term senior living community, from independent living through nursing homes. He has actively participated in long term care peer organizations and served on numerous boards and committees in the nursing home/assisted living community field. Formerly, this expert was an administrator at Hampton Court Nursing and Rehabilitation Center, a 120 bed nursing home and rehabilitation center, and Lake View Care Center/Coral Gables Nursing and Rehabilitation Center, an a 88 and 120 bed nursing home, responsible for the full range of management functions. Previously, this expert was the executive director of residential living at Miami Jewish Health Systems, where he was responsible for six Alzheimer's facilities and Alzheimer's Day Care. Currently, this expert is a consultant in the long term care field.
Consultant, An assisted living consulting firm in FL
Master of Business Administration (MBA), University of Pennsylvania
Coral Springs,
Florida
This extremely qualified expert with licensed nursing home administrator with years of experience in the field. She received both her B.Ed. and M.Ed. degrees from the University of Toledo and completed her post-graduate training in healthcare and business administration at the University of North Carolina, the University of Toledo and Ashland University. She had fellow status at the American College of Healthcare Administrators and a member of several other professional associations. She is a former executive nurse at Mississippi State Hospital and a former long term care consultant at Omnicare Westhaven. She is also the former nursing home administrator and director of nursing a The Ohio Veterans Home and the former Director of the critical care and post anesthesia units at Firelands Community Hospital. Currently, she works as a Hospital, Nursing Home and Behavioral Health Surveyor for a major healthcare accreditation company.
Hospital Surveyor, A Major Healthcare Accreditation Company
Postgraduate (PG), Ashland University
Waterville,
Ohio
This highly qualified expert earned her PharmD from Midwestern University College of Pharmacy Glendale. She continued her post graduate education with a residency in Acute Care Pharmacy Practice and a residency in Geriatrics. She is a member of the American Society of Consultant Pharmacists and a Member of the Arizona Pharmacy Association. This expert has been the recipient of distinguished honors and awards such as AzPA Geriatric Care Academy Service Award. She has published 10 peer-reviewed journal articles. She is a former Visiting Instructor from Midwestern University College of Pharmacy Glendale. She currently serves as current Adjunct Faculty from a major university and a Long Term Care Clinical Consultant Pharmacist from a private consulting group.
Long Term Care Clinical Consultant Pharmacist, Private Consulting Group
Doctor of Pharmacy (PharmD), Midwestern University College of Pharmacy Glendale
Phoenix,
Arizona
This board certified expert who is the president of the American Medical Directors Association for his state earned his BA from Boston University. Residency training was completed at the University of Connecticut. He has made over 15 presentations and has over 15 original peer reviewed articles in his over 20 years of clinical practice. The expert frequently lectures on numerous topics in geriatrics such as dementia, medical direction in long term care and hospice, and hospice in long tern care. He is a member of multiple medical associations, some of which he sits on the board. Currently, he is a Professional Director at an independent health program/ network, a Medical Director for an independent rehabilitation center/ nursing home, and an Assistant Clinical Professor of Medicine at a university affiliated medical center/ program.
Primary Care Physician, A Healthcare Medical Group in CT
Doctor of Medicine (MD), American University of the Caribbean School of Medicine
Newington,
Connecticut
This board certified physician is currently an active consultant in medical billing compliance, device and drug marketing, and claims data analysis. He has recently been involved as consultant and expert witness in Medicare criminal and civil litigation, Qui Tam cases and administrative hearings. The expert recently served as a Medical Consultant for ICD-10 transition, coding, and policy at PricewaterhouseCoopers; he now runs his own consulting business and assists clients with all areas of Medicare coverage and billing.
Consultant, A private medical billing consulting business
Doctor of Medicine (MD), University of Illinois Abraham Lincoln School of Medicine
Chicago,
Illinois
This expert has over 40 years' experience as a registered nurse and administrator in various settings including acute care, home care, and long term care. She is proficient in patient assessment, care planning and collaboration with other healthcare providers. She brings extensive experience in developing, reviewing, and implementing policies and procedures to assure facility compliance with state and federal regulations and standards of care. This expert is currently a self-employed legal nurse and long term care consultant.
Long-Term Care Consultant, A private consultancy in RI
Bachelor of Science (BS), Salve Regina College
Pawtucket,
Rhode Island
With a career in the home care industry spanning 35 years, this registered nurse has had hands on experience in both the administrative and clinical aspects of the field. She progressed to senior executive levels within a multi-million dollar national home care company with locations in 28 States. She has been instrumental in the creation and oversight of many aspects of home care businesses including policy and procedures, caregiver training and training manuals, business development, clinical services, contracting, quality improvement, compliance, reimbursement and human resources. She earned a Bachelor of Science degree in Nursing from Michigan State University and has pursued graduate course work in business administration. She currently serves as a board member of the National Association of Home Care and Hospices Private Duty Home Care Association.
Independent Consultant, Home Care Industry
Bachelor of Science in Nursing (BSN), Michigan State University
Bloomfield Hills,
Michigan
This highly experienced actuary specializes in long term care insurance. He began his actuarial career at the Fireman's Fund Life Insurance Company in San Francisco and later transferred to Genworth Financial. For more than a decade, he served as an actuary with LifeCare Assurance Company in Los Angeles, focusing on the long term care field. He now is an actuarial consultant with a specialty in long term care and product pricing.
Consultant in the Field of Long Term Care
Bachelor of Science (BS), SUNY Stony Brook
Bellows Fall,
Vermont
This expert has been the managing partner of a homecare firm for more than twenty years. Arizona Business Magazine has ranked this expert's firm among the top home health care agencies in the state for several years running, and he has been a recipient of the Better Business Bureau’s Business Ethics Award Winner. Additionally, he was selected to the advisory board for the Arizona Attorney General’s Taskforce Against Senior Abuse, advising the Arizona Attorney General on issues concerning seniors and spreading awareness on ways to prevent senior abuse and exploitation.
Managing Partner, A Home Health Agency in the Southwest
Bachelor of Science (BS), Ithaca College
Arizona
This qualified expert received his PhD in architecture and environment-behavior studies from the University of Wisconsin-Milwaukee, MS in architecture from Texas A&M University, and his BArch in architecture from the Bangladesh University of Engineering and Technology. He is a fellow of the Gerontological Society of America and a member of the Environmental Design Research Association. He has conducted extensive research in the areas of seniors' housing, nursing home design, design for people with dementia and neighborhood for active aging. He has published 60+ peer reviewed articles, books, edited volumes, and book reviews. Currently, he serves as the department chair and a professor of gerontology at a prestigious CA university.
Department Chair, A top CA university
Doctor of Philosophy (PhD), University of Wisconsin-Milwaukee
Vancouver,
British Columbia
This expert served for many years as the Chief Research and Development Officer, President and Founder of a long-term care research and risk management company. He has conducted extensive research and analysis on a variety of public policy issues affecting the financing and delivery of long-term care services. He has published widely in scientific journals and his work has been quoted extensively. He has been interviewed by The New York Times, Wall Street Journal, and Time Magazine as a thought leader on issues affecting elder care financing. He earned his PhD from Brandeis University and is a full professor at a respected university in New England.
Director - Center for Long Term Services, A New England University
Doctor of Philosophy (PhD), Brandeis University
Boston,
Massachusetts
This expert has extensive credentials and training in nursing, nurse life care planning, and medicare consulting. She belongs to the American Association of Legal Nurse Consultants, the American Association of Nurse Life Care Planners, and the National Association of Medicare Set-Aside Professionals. She has held numerous nursing positions throughout the mid-west and is currently a nurse life care planner and consultant at a private firm in Indiana.
Nurse Life Care Planner and Consultant, A private consultancy
Bachelor of Science in Nursing (BSN), University of Phoenix School of Nursing
Muncie,
Indiana
This expert has over 30 years of experience with healthcare and health insurance. She gained her PhD in sociology and health policy at the University of California, Santa Cruz and directed research at the Institute of Health and Aging at UC San Francisco before leading the White House's Health Care Reform Task Force. Since, she has continued to contribute to the private and public sectors, working as a principal at William M. Mercer, Inc, the vice president of the Lewin Group, an associate professor of research at UC Santa Cruz, and the consumer representative to the Medicare Coverage Advisory Committee. Her most recent roles include consulting for Watson Wyatt Worldwide, the Center for Medical Technology Policy, and Bain & Company. Currently she is an independent health care consultant.
Consultant, A healthcare consultancy in California
Doctor of Philosophy (PhD), UC Santa Cruz
Westlake Village,
California
This highly qualified expert is a licensed pharmacist practicing in the state of Florida for the past 36 years. He has filled 500,000+ prescriptions, performed 150,000+ medical chart reviews, and participated in 200+ state and federal surveys. He completed his post baccalaureate studies in biochemistry and pharmacy at the University of Florida and is board certified in geriatrics pharmacy. He is a member of the American Society of Consultant Pharmacists and the former pharmacy manager of numerous pharmacy groups, including RX Express Pharmacy Inc. and CR Pharmacy Inc. He is also the former president of Select Pharmacy Services and the former director of consulting services at Medistat Pharmacy Services. Currently, he is the director of consultant and management services at a major health advisors group and a professor of pharmacy at three major pharmacy colleges.
Clinical Assistant Professor, A College of Pharmacy in FL
Bachelor of Science (BS), University of Florida
Miami,
Florida
This qualified nursing home administration expert earned her BA in international hospitality management from the University of Tourism and Transport Studies and her MA in marriage and family therapy from Alliant International University. She is licensed in marriage and family therapy, residential care for the elderly and as a nursing home administrator. This expert has formerly served as a multi-site nursing home administrator for Elmcroft Senior Living and as a nursing home administrator for Premier Healthcare. Currently, she is the assisted living memory care executive director at a senior living management center.
Assistant Medical Services Administrator, A County in CA
Master of Arts (MA), Alliant International University
Jamul,
California
This highly qualified nurse has extensive experience in her field. Her areas of expertise include long term care, skilled, medical-surgical, and telemetry nursing. She received her AS in nursing from Meridian Community College, her BS in nursing from the University of Alabama, and her MS in nursing from Loyola University. Formerly, she has served as an occupational health RN at Nursing Corp Inc., an RN supervisor at the Bedford Care Center of Marion, and as a medical surgical/telemetry nurse at RN Network. Currently, this expert is a training and development coordinator for a MS healthcare management corporation.
Training & Development Coordinator, A MS healthcare management corporation
Master of Science (MS), Loyola University
Hattiesburg,
Mississippi
This well-qualified expert has been in the field of geriatric medicine for over 25 years. After earning his BA from Pitzer College, he went on to earn an MPH from the Harvard School of Public Health. He earned his MD from The University of Rochester School of Medicine and Dentistry and went on to complete an Internal Medicine residency at Harbor UCLA Medical Center. He then completed a fellowship in geriatric medicine at Harvard Medical School and a postdoctoral fellowship at Brown University. He has over 150 peer reviewed publications and is recognized as a leader in the field of exceptional longevity. He is founder and director of the New England Centenarian Study and a principal investigator of the Long Life Family Study and the Longevity Consortium, funded by the National Institute on Aging. Currently, he serves as a professor of medicine at Boston University and a Senior Attending for the geriatrics section at Boston Medical Center. This expert is also a telemedicine physician for ~8 nursing homes in Massachusetts and Maine, covering weeknights and weekends for acutely ill SNF patients.
Attending Physician, A medical center and three nursing homes in MA
Doctor of Medicine (MD), University of Rochester School of Medicine & Dentistry
Beverly,
Massachusetts
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What Can a Medicare Expert Witness Opine On?
Annual Wellness Visit
Comprehensive evaluation of health risks.
Preventive Screenings
Tests for early disease detection.
Vaccinations
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Ongoing care for chronic conditions.
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FAQs for Medicare Expert Witnesses
What is a medicare expert witness?
A Medicare expert witness is a healthcare or billing professional who explains Medicare rules and standards in legal cases. They assist by reviewing records, analyzing billing, and testifying to clarify Medicare compliance issues.
What types of cases may benefit from the insights of a Medicare expert witness?
A Medicare expert witness supports fraud, billing, reimbursement, coverage denial, medical necessity, compliance, overpayment, and False Claims Act litigation cases.
How can a Medicare expert witness assist with interpreting CMS regulatory guidance?
A Medicare expert witness can clarify complex CMS regulatory guidance, explain how rules apply to specific cases, and support compliance or dispute resolution in court.
What qualifications should attorneys require from a Medicare expert witness?
Attorneys should require a Medicare expert witness to have clinical or billing experience, CMS regulatory expertise, relevant certifications, and prior credible testimony in Medicare cases.
How does a Medicare expert witness evaluate billing and reimbursement disputes?
A Medicare expert witness evaluates billing and reimbursement disputes by reviewing medical records, coding, claims data, and Medicare regulations to assess compliance and payment accuracy.
What is Expert Institute’s process for selecting medicare expert witnesses?
Expert Institute delivers a tailored approach to connect you with top-tier experts. We identify actively practicing professionals who meet your exact criteria for specialty, experience, litigation background, fee structure, credentials, location, and more.