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Dennis Coleman
10 Chaucer Lane
Ventura CA 93003
United States
phone: 6613136579
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Dennis E. Coleman, JD, MPH, has over 40 years of experience in Hospital and Healthcare Management. In 1990, he formed his own hospital administration / healthcare management services consulting firm provide healthcare management services to various healthcare provider clients in a variety of areas, including strategic planning, business development, operations management, sales and marketing, policy & procedure development, and human resources management.

Mr. Coleman's academic background includes a Juris Doctor degree from Southwestern University in Los Angeles and a Masters in Public Health degree with a Hospital Administration major and a Bachelor of Arts degree in Political Science, both from the University of California, Los Angeles.

Litigation Support - As a hospital administration expert witness consultant, Mr. Coleman is an advocate for applying community standards which are relevant, based upon the time frame, subject matter and administrative practice(s) appropriate to each case. He has consulted and provided case review, expert witness services, and/or strategic litigation preparation services in more than 200 legal matters. He accepts cases on behalf of Plaintiffs or Defendants.

Mr. Coleman is willing to serve as either a work product consultant or a designated expert based upon the particular strategic litigation needs of each case.

Cases Include:
  • Medical Staff Credentialing & Clinical Privileging / ELAM
  • Negligent Credentialing, Negligent Supervision, Negligent Retention
  • Hospital / Physician Relations-MEJIA Ostensible Agency Issues
  • Administrative Community Standards
  • Medical Staff Bylaws, Rules & Regulations
  • Provider-Based Physician Contracting Negotiations & Contract Administration
  • Administrative Policies & Procedures
  • Hospital Joint Commission Accreditation, Licensing & Regulatory Compliance Issues
  • Wrongful Termination / Constructive Discharge / Whistleblower Issues
  • Patient rights; Informed Consent
  • Patient Safety; Environment of Care
  • Governance; Corporate Negligence
View Dennis Coleman's Consulting Profile.
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Andrew F. Richards, CFS
President
2199 Almanack Court
Pittsburgh, PA 15237
USA
phone: 412-722-8380
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Andrew F. Richards, CFS is a recently retired federal agent with over 25 years’ experience investigating White Collar Crimes. As head of the Fraud Section of the U.S. Postal Inspection Service, he handled almost every type of scheme and scam committed on businesses, government entities, and individuals. Prior to his federal experience Andrew was a Reading (PA) police officer for five years in. He has a BA in Criminal Justice and a Master’s Degree in Criminology.

As a National Fraud Subject Matter Expert (SME) for USPIS and supervisor of the Financial Crimes/Major Crimes section, a nationally recognized multi-agency task force, Mr. Richards supervised task force members from the FBI, US Secret Service, US Treasury- Inspector General, US Attorney’s Office, PA Attorney General’s Office, and many more. He has covered criminal conduct in both the Western District of Pennsylvania and the Northern District of West Virginia.

Areas of Expertise:
  • Internal and External Corporate Investigations
  • Fraud and Theft Investigations
  • Whistleblower / Qui Tam Actions
  • Corporate Fraud
  • Commercial Corruption
  • Investment Fraud
  • Health Care Fraud
  • Worker's Compensation Fraud
  • Mortgage Fraud
  • Vendor Fraud
  • Extortion
  • Bribery
  • Insurance / D&O Insurance Fraud
  • Political Corruption
  • Employee Investigations
  • Identity Theft
  • Surveillance
  • Computer and Asset Recovery
  • View Andrew Richards' Consulting Profile.
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    Mary Wickens, JD, CFE
    2237 Raby Road
    East Lansing MI 48823
    USA
    phone: 248-770-4906
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    Mary Wickens, JD, CFE has over 35 years experience in the Healthcare Insurance, Managed Care, and Compliance Industry. Her experience includes advising and counseling health care providers, insurers, government contractors, and others in compliance, ethics, fraud and abuse, Medicare, Medicaid and Federal Employees Plan, managed care, and other matters.

    Background Experience - Ms. Wickens is a former compliance officer for a major health insurer and former legal and compliance specialist for a CMS Medicare Program Safeguard Contractor. Also a former operations director for government programs (Medicare Part C, Medi-gap, and FEHBP) for a major HMO, she is experienced with government audits and investigations, commercial audits, as well as self-reporting and internal investigations.

    Ms. Wickens has decades of experience as in house counsel to HMOs and health insurers. She has drafted, developed, negotiated, and implemented numerous healthcare provider-payor contracts, and developed and implemented codes of conduct, ethics programs, compliance programs and numerous corrective action plans.

    Litigation Support - Mary Wickens provides litigation support, including skilled expert services, reports and testimony in federal False Claims Act cases, arbitrations, and provider-payer disputes. She is an experienced testifying expert, responsive to the needs of counsel, with excellent report writing skills. Ms. Wickens' services are available to counsel representing both plaintiff and defendant.

    Areas of Expertise:
    • Medicare
    • False Claims Act (FCA)
    • Health Insurance
    • HMO
    • Medicare Advantage
    • Provider / Payor Disputes
    • Claims Audits and Appeals
    • Federal Employees Health Benefits Plans (FEHBP)
  • Medicare Part D
  • Government Audits
  • DME
  • Home Health Care
  • Hospice
  • Managed Care Contracting
  • Anti-Kickback Compliance
  • Self-disclosures
  • View Mary Wickens' Consulting Profile.
    6/6/2018 · Healthcare
    The US Department of Justice (DOJ) recently joined a federal qui tam lawsuit1 brought against a private equity firm that specializes in health care pharmacies. Notably, the case also charges individual partners of the private equity firm, Riordan, Lewis & Haden, Inc. (RLH) based in Los Angeles2. They are charged with violations of the federal Anti-Kickback Statute (AKS) and the federal False Claims Act (FCA) in connection with their management of Diabetic Care Rx/Patient Care America (PCA), a compounding pharmacy. The case involves reimbursements from TRICARE, the health care program for the military and their families.

    4/12/2017 · Healthcare
    Health care fraud and abuse cases are often won or lost on the effective use of expert witnesses. As health care fraud cases have become more complex and technical, the scope and use of expert testimony has proliferated, and the successful use of experts is one of the lawyer's most important jobs. False Claims Act, Anti-Kickback Statute, and Stark Law cases all demand various types of experts to assist the trier of fact in understanding the nature of the case, the morass of rules at play, the evidence, and a variety of billing, valuation, contractual, technical, and compliance concepts. Increasingly, expert reports and testimony play a pivotal role in motions for summary judgment, as well as at trial. Experts also are used in "conference room litigation," such as mediations or negotiations between defense counsel and enforcement agencies. This article is the result of interviews with health care fraud litigators and expert witnesses in the field who identified their best practices to produce optimum outcomes for their clients.

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    Patrice Morin-Resch (formerly Morin-Spatz)
    CPC, CMCS, CHCI, CPMA
    1300 Shamrock Lane
    Plano TX 75093
    USA
    phone: 972-955-4855
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    Patrice Morin-Resch (formerly Morin-Spatz), CPC, CMSCS, CHCI, is a professional Medical Coding and Reimbursement subject matter expert supporting clientele throughout the United States with more than 30 years of experience in her field.

    Ms. Morin-Resch is a former editor of the American Medical Association’s (AMA) Current Procedural Terminology (CPT®) book, and a published author of more than 15 books on coding. Her legal and coding expertise has been utilized by the Department of Justice, Department of Defense, attorneys, insurance companies, clinics, medical associations, and organizations.

    Whether testifying for medical fraud and abuse cases, assisting in the recouping of monies for physicians, providing medical coding seminars, audits, in-house consultations, superbill reviews or fee slip analysis for clients, her emphasis and expertise remains solely on medical coding and reimbursement. Ms. Morin-Resch services are available to attorneys representing both Plaintiff and Defense. She has testified in district, state, and federal court.

    Areas of Expertise:
    • Usual, Customary & Reasonable(UCR) Fees
    • Medicare Standard Fees
    • Fraud & Abuse
    • Bundling / Unbundling
  • Medicare & 3rd Party Payments
  • Medicare Audits
  • Double Billing
  • RICO & Qui Tam Cases
  • View Patrice Morin-Resch's Consulting Profile.
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