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Featured Healthcare articles by expert witnesses and consultants. Contact Us if you are interested in having your work published on our website and linked to your Profile(s).

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4/3/2018· Healthcare

CDI as a Foundation of Value-Based Care

By: Michael F. Arrigo

Clinical documentation improvement (CDI) initiatives are underway in healthcare organizations across the country, with the aims of improving care and reducing costs. Are they working? At least one such initiative, at Baptist Health South Florida, is providing solid return on investment.

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3/2/2020· Healthcare

Coronavirus (COVID-19)Who's in Charge and What are They Doing About It?

By: Mary Wickens

This brief describes: Which government agencies and health care providers have power to act and what are those powers? Who controls testing and reporting results and who has the power to isolate individuals, impose quarantines and take other steps to mitigate the outbreak.

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2/6/2020· Healthcare

Four Reasons Why Healthcare is Expensive in America

By: David Haass

It seems to be common knowledge that healthcare in our nation is outrageously expensive. But why is this? In the United States, we see healthcare costs that are nearly double than compared to any other developed nation in the world.

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4/12/2017· Healthcare

Getting the Most from Health Care Fraud Expert Witnesses: Lawyer and Expert Best Practices

By: Mary Wickens

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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10/21/2015· Healthcare

How to Avoid a Clinical Fair Hearing

By: Dr. Jonathan Burroughs

Not too long ago, I had the sad task of testifying at a civil litigation and a judicial hearing for two physicians who had been suspended from their respective medical staffs. In both cases, the suspensions and resultant procedural rights were avoidable because proactive communication and management did not effectively take place. Such events should be rare and most medical staffs can easily avoid them by focusing on preventive actions and addressing potential performance issues early in a supportive and assertive manner.

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11/27/2008· Healthcare

It Started With Joe

By: Carol Bradley

It started with Joe. My elderly neighbor had lost his wife and his only child lived in New Jersey. He was totally deaf. How could I not help? My children were then young, and we adopted Joe. How could I have known he would become my charge for over five years

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11/11/2015· Healthcare

Population Healthcare: Strategies to Survive a Brave, New Value-Based World

By: Dr. Jonathan Burroughs

Population health is not possible in a discounted fee-for-service world, and the significant healthcare business challenge is how to transition from fee-for-service to risk-based capitation in a sustainable way. The following represents an outline for how this transition can be staged so that early steps exploit the benefits of fee-for-service while the latter ones exploit a more capitated model:

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6/6/2018· Healthcare

Private Equity and Health Care Fraud – A New Frontier?

By: Mary Wickens

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.

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10/2/2019· Insurance

Soaring Insurance Deductibles and High Drug Prices Hit Sick Americans with a Double Whammy

By: David Haass

In the national debate over health insurance, the Affordable Care Act gets the spotlight. However, most Americans don’t get their health insurance on the ACA's exchanges. They have insurance through their employers.

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7/24/2015· Healthcare

The Regulatory Challenges Facing E-Health

By: Dr. Jonathan Burroughs

Regulatory hurdles prevent more hospitals from using e-health to its full potential. Federal and state policies and regulations on care rendered via technology from a remote site spin a tangled web for providers either engaged in e-health or who want to be. A February 2014 article in Health Affairs found strong associations between state policies and hospitals' adoption of e-health, also known as tele-health or telemedicine.

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