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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 highly-qualified expert has nearly three decades of experience in the field of geriatric and long term skilled care nursing. She earned her BSN from American Sentinel University, her MSN from Maryville University, and her DNP from Walden University. She is board certified in gerontological nursing, certified in long term care administration nursing, and is a licensed registered nurse. She is active in her field as a member of several professional organizations, including the American College of Healthcare Executives and the Gerontological Advanced Practice Nurses Association. This expert was formerly the assistant director of health services and then was promoted to the director of health and nursing services at a PruittHealth Corporation long term care facility. She then went on to become the director of nursing, first at Southland Health and Rehab and then at Golden Living, where she was responsible for both acute and long term care, before serving as the ambulance clinic clinical nursing manager at Grady Memorial Hospital. Currently, this expert is a clinical instructor at a state college in Georgia and a director of nursing, in charge of acute care, long term care, and rehabilitation, at a large long term residential care facility in Georgia.
Director, A Medical Center in GA
Doctor of Nursing Practice (DNP), Walden University
Ellenwood,
Georgia
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 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
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What Can a Medicare Expert Witness Opine On?
Annual Wellness Visit
Comprehensive evaluation of health risks.
Preventive Screenings
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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.