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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 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 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 expert has been in the field of nursing for over four decades, with demonstrated experience in the areas of life care planning, medical cost projection, Medicare set asides, medical damage reports, and medical bill reviews. She received her BSN from Saint Olaf College and then her MS in nursing from Ohio State University. She is a registered nurse, as well as a certified legal nurse consultant, lifetime nurse care planner, medicare set aside professional, and nurse life care planner. She is a member of numerous professional societies, including the American Association of Legal Nurse Consultants and the American Association of Nurse Life Care Planners and has presented on topics in nursing multiple times. She has held a wide variety of roles during her career including as the owner and manager of Home Health Care Consultants. She has also worked as an office nurse for a primary care physician and as a home care liaison at St. Mary’s Regional Medical Center. Currently, she is the owner and CEO of a legal nurse consultancy in Nevada.
Owner & CEO, A legal nurse consultancy in NV
Master of Science (MS), Ohio State University
Nevada
This expert has over 25 years of experience in healthcare administration with the majority of his experience focused on eldercare and senior living facilities. He has managed facilities ranging from 75 to 269 beds, in settings ranging from critical care to long term care including cardiology, orthopedics, rehabilitation services, dementia care, and assisted living. This expert is a licensed nursing home administrator and a certified residential care facility for the elderly administrator. Currently, he is the administrator of a skilled nursing facility with nearly 200 beds in California.
Administrator, A skilled nursing facility in CA
Master of Business Administration (MBA), Wright State University
San Diego,
California
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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
Immunizations to prevent illness.
Chronic Disease Management
Ongoing care for chronic conditions.
Home Health Services
In-home care for health needs.
Physical Therapy
Rehabilitation to improve mobility.
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.