Managed Care Liability Consultants: 11

Georgia J. Persky RN, MBA, PhD, CLNC, is a seasoned nurse with over 40 years of broad Clinical Nursing experience and 25 years of Senior Leadership in Healthcare Organizations. She has expertise in the micro issues in direct patient care and the broad Management, Quality, State, Federal, and Joint Commission regulatory issues in hospitals and long term care facilities. Dr. Persky provides private consulting for hospitals that want to improve patient care quality and satisfaction. A national speaker and author, her services are in demand for engagements on healthcare issues. 

Litigation Consulting Support - As a Certified Legal Nurse Consultant and Quality Reviewer, Dr. Persky has investigated hundreds of Malpractice and Injury cases as a quality reviewer and can assist in legal case review with chronologies, timelines, and evidence based reports. Dr. Persky's services are available to attorneys for plaintiff and defense seeking an expert in nursing and patient care with a strong understanding of how hospitals and nursing homes work. 

Facility Consulting Services:

• Provide hospital and nursing leadership and support in turnaround or acute regulatory situations
• Assess, plan, implement and evaluate Patient Care Services structure, processes and patient satisfaction initiatives
• Mentor nursing leadership team or screen and recruit new leadership
• Recommend strategies and tactics to improve efficiency or effectiveness in nursing and hospital operations
• Assess Perioperative Services and improve volume and patient flow
• Provide focused plan and implementation to address regulatory and accreditation issues and prepare leaders and staff for regulatory visits
• Develop Nursing, Operational and Strategic plan for handoff to new leadership team

Background Experience - Dr. Persky has served as Vice-President of Nursing and Patient Care Services for 25 years and most recently, New York Presbyterian Hospital at Columbia University Medical Center. For nine years, she was responsible for Risk and Quality Management and Patient Satisfaction for a 750 bed academic hospital. She directed a $200 million budget with 33 patient services units and Care Management, Respiratory Therapy, Social Work and Admitting Departments with 9 direct reports and 2,000 patient care employees. 

View Dr. Persky's Expert Witness Profile.

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2020 07 21 Michael F Arrigo Expert CV and Supplemental Material WATERMARK NOT RETAINED.pdf

I am the Managing Partner, Healthcare Practice for our firm, and I am a testifying expert witness.  I work with health systems, health IT companies, and health plans. Recent retentions by the U.S. Department of Justice (DOJ). Drug pricing, patent infringement, medical coding, and billing and Qui Tam False Claims Act and fraud case specialties. He has in-depth experience in HIPAA mandates, the HITECH Act and Patient Protection and Affordable Care Act (PPACA), and is a published author and regular speaker. He consults to clients including Health IT investors, Health IT companies, and health plans and hospital systems in matters regarding HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Breaches, Revenue Cycle Management

• Meaningful Use of Electronic Health Care Records
• Quality Measures for Medicare Advantage Hospital Value-Based Purchasing
• Medicare Advantage HEDIS 5-Star Ratings for Health Plans Mr. Arrigo was recently quoted in the Wall Street Journal Venture Capital Dispatch regarding medical coding standards and Wall Street Journal Health Blog regarding venture-backed information-technology companies that serve hospitals and health insurers.
• Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)

Milliman’s Tampa Office provides Health Insurance, Health Care and Employee Benefit Consulting to law firms, insurance companies, hospitals, HMO’s, Blue Cross/Blue Shield plans, employers and government agencies. Our staff is experienced with medical, dental, long-term care, Medicare supplement & critical illness.

We assist clients nationwide with forensic actuarial work, rate filings, regulatory compliance, reserve projections, valuations, employee benefit analysis and design, mergers and acquisitions, demutualizations, claim cost analysis, and utilization management programs.

These health care services are used in litigation relating to:

• Pricing & Underwriting
• Senior Services
• Contract Development and Negotiations
• New Plan Design

M.K. Wickens, PLLC, is a Health Care Fraud and Compliance company. Principal, 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.

Consulting Services:

• Internal Investigations - As a highly experienced investigator, Mary Wickens is available to provide swift and thorough review of potential compliance and ethics issues. She is seasoned at handling potential whistleblower concerns, C-suite investigations, and reporting for self-disclosures. She provides comprehensive, understandable reports and recommendations to executives, audit committees, and auditors.
• Compliance Consulting - Ms. Wickens is experienced in providing site reviews, red team reviews, and independent compliance reviews. She has in-depth knowledge developing and implementing effective corrective action plans and extensive experience in responding to government and commercial audits and investigations.

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. Ms. Wickens has authored numerous professional publications and presentations on health care fraud and compliance, government and commercial audits, compliance programs, and healthcare contracting.

View Mary Wickens' Expert Witness Profile.

Lynn M. Shaffer, RN, CLNC®, is Registered Nurse with certification in Legal Nurse Consulting and the founder and managing member of Legal Nurse Consultants of CNY, LLC. Ms. Shaffer's 20 years of nursing experience includes clinical practice in hospitals, outpatient clinics and physician offices, and supervisory roles. She has specialized in Long Term Care / Rehabilitation for most of her nursing career.

Litigation Support - Ms. Shaffer provides consulting and expert witness services for attorneys’ cases including criminal, disability, personal liability, toxic tort, and medical malpractice (specializing in long term care). As a Certified Legal Nurse Consultant, she assists insurance companies and attorneys with screening cases for merit, locating medical and nursing experts, and analyzing and interpreting medical records for both plaintiff and defense.

Ms. Shaffer's CLNC® services also include: development of reports, timelines and chronologies to highlight the significant medical events, identify adherences to and deviations from applicable standards of care, and assess injuries and identify causation issues and pre-existing contributing factors. She also attends and reports on Independent Medical Exams in the Central New York areas.

Areas of Expertise:

Geriatrics Independent Medical Examinations Long Term Care / Rehabilitation Managed Care Medical Malpractice Medical Records Review Nursing Home Malpractice Nursing Home Medical Malpractice Nursing Home Safety

Nursing Home Staffing / Training Nursing Homes Standards of Care Nursing Malpractice Nursing Policy & Procedures Personal Injury Disability Wrongful Death

Kohler Healthcare Consulting, Inc., is an effective, cutting-edge Healthcare Consulting firm employing credentialed nurses, accountants, and coders since 1980. With clients across the United States and Virgin Islands, Kohler Healthcare Consulting has extensive relationships with healthcare organizations including academic medical centers, large and small hospitals, critical access hospitals, physician / medical practices, long term acute medical facilities skilled nursing facilities, and other healthcare providers.

Consulting Services:

Revenue Cycle Fiscal and Clinical Operational Improvement Financial Operations

Regulatory and Compliance Consulting Education and Training Due Diligence

Charlotte L. Kohler, [RN], CPA, CVA, CRCE-I , CPC, CHBC, President of Kohler HealthCare Consulting, Inc., specializes in litigation, investigation, accounting, auditing, and consulting. She has over 30 years of healthcare experience starting with the clinical side of nursing to the finance and compliance side of healthcare.

During her years at Kohler HealthCare Consulting, Ms. Kohler and her firm provided regulatory compliance services to over 60% of all hospitals in Maryland as well as hospitals and other health related organizations outside of Maryland. She continues to provide reimbursement regulatory support to attorneys regarding billing, coding, and documentation in the areas of home care, radiology, hospital billing, DME, Therapy, ASC, anesthesia, and physician practices. She also provides services as an independent review organization for providers under Integrity Agreements.

Dr. Vipul Kella, MD, MBA FACE, is a board-certified Emergency Medicine Physician and Health Care Consultant who advises hospital, health systems, and startup companies on clinical Best Practices and Policies. 

As the founder of Insight, MD, LLC, Dr. Kella advises healthcare startups, hospitals, and health systems. His clients include venture capital startups, digital technology companies, telemedicine companies, medical-legal firms, and health systems. 

Dr. Kella provides consulting services in the areas of:

Competitive Strategy and Intelligence - Clinical Best Practices - Medicolegal Issues - Medicolegal Risk

Dr. Kella is currently a Partner, clinician, and played a key role in the business growth of US Acute Care Solutions (USACS) while serving in hospital administrative and executive roles. He is recognized for clinical expertise, efficiency, innovation, and quality programs. Prior to his role at USACS, he served as the Hospital-Based Physician Chairman of Southern Maryland Hospital in Clinton MD. He was responsible for a turnaround of a distressed 65+k visit ER, and led numerous initiatives to improve staffing, quality, safety, and culture.

Dr. Kella is also an Investor and advisor for Global Health Impact Fund, a venture capital fund with a portfolio of early-stage healthcare technology companies.

View Dr. Vipul Kella's Expert Witness Profile.

Expert Witness: Retained in Washington, D.C., and over 25 states as an expert in hospital administration who could render opinion after assessing medical records, hospital policies and procedures, medical staff bylaws and regulations, JCAHO standards, depositions, etc. Served as Expert Witness for Plaintiff and Defense. 

Consultant: Has assisted hospitals and health systems with accelerating their performance improvement efforts. Speaks, writes and consults on ethical issues in health care. 

Background Highlights:

• Consultant, Executive Vice President and Chief Operating Officer of the health system.
• Executive Director of two academic medical centers: Emory University Hospital in Atlanta, Georgia, Stanford University Hospital and Clinics at Stanford.
• Past chairman of the national advisory board for the University of Chicago’s Center for Clinical Medical Ethics.
• An author of over 175 publications, he has written articles for USA Today, Health Management Quarterly, Trustee, Health Progress, the Journal of Health Administration Education, Frontiers of Health Services Management, Bioethics Forum, Modern Healthcare, the Cambridge Quarterly of Healthcare Ethics, Stanford Medicine, and Healthcare Executive among others.
• Co-editor of Management Mistakes in Healthcare: Identification, Correction, and Prevention, published by Cambridge University Press in 2005.
• Co-editor of Managing Ethically: An Executive's Guide, published by Health Administration Press in 2001, and a second edition, Managing Healthcare Ethically: An Executive's Guide was published in 2010.
• Fellow of the American College of Healthcare Executives, a past member of its Leadership Advisory Committee, and a consultant on health care management ethics since 1994.
• Served as a Distinguished Visiting Scholar at Stanford University’s Center for Biomedical Ethics.
• Recipient of American Hospital Association's Award of Honor in 2009 and an Albert Schweitzer Leadership Award in 2012.
• Faculty appointments held at Harvard, UCLA, Stanford, Emory, the University of California, and Seton Hall University.
• Bachelor of Science, Master of Public Health, and Doctor of Public Health degrees are from the University of California, Berkeley.

Constance J. Paine CCRN, LNC, is a Legal Nurse Consultant with over 40 years of nursing experience. Currently the Principal at CP LegalMed Consulting and a Staff Nurse in ICE at UC San Diego Health System, Ms. Paine specializes in Critical Care, Interventional Radiology, Medical Surgical, and Discharge Planning.

In addition to her comprehensive services to the legal community, Ms Paine serves as an educator, mentoring new graduates and educating staff on special procedures. She also serves in hospital settings evaluating staff and reviewing and revising hospital policy and procedure. Ms. Paine's fields of expertise include:

Acute and Critical Care in Hospital Setting:

• Pre-operative Teaching
• Post-operative Care and Instruction
• Discharge Planning for Home or Extended Care
• Infection Control for In-patients
• Wound Care and Instruction
• Intravenous Therapy
• Coordination of Individualized Care Plans

Interventional Radiology:

• Pre-Procedure Instruction
• Management of Conscious Sedation
• Discharge Teaching

Neonatal Intensive Care:

• Care of Level 1 Neonates
• Parental Teaching and Support

View Constance Paine's Expert Witness Profile.

Yolanda Anderson, RN, BSN, CEN, CLNC is a Registered Nurse and has been working in the Emergency Department for more than 25 years. She began work in the Emergency Department of Los Angeles County, USC Medical Center, a level I Trauma Center. She then worked in the Emergency Department at Saint Anthony Hospital Central in Denver, Colorado, a level I Trauma Center where she helped initiate the Hyperbaric Medicine program. For 15 years, she was employed as a staff RN, Charge RN and Assistant Nurse Manager in the Emergency Department at Littleton Adventist Hospital - Littleton, Colorado, a level II Trauma Center. There, she helped with the expansion and reconstruction of the current Emergency Department facility.

A Certified Legal Nurse Consultant, Ms. Anderson is knowledgeable about all aspects of Hospital Care and Standards of Care for Physicians, Nurses and Ancillary Personnel. Her consulting services include:

• Hospitals, Clinics, and Offices - Consult and organize for the development and expansion of a new facilities or offices and related care patterns
• Personal - Consult with family members to organize health care history, needs, and medications and to help understand healthcare information and interpretation
• Teaching - Emergency Nurse Pediatric Course Instructor, Triage Class instructor, Charge Nurse class instructor

View Yolanda Anderson's Expert Witness Profile.

Paul M. Adler, DO, FACEP, MBA, Medical Director for the Ventura County, California, Department of Corrections, has worked in Correctional / Jail / Prison Medicine & COVID-19 Preparation & Response. He has overseen the care of inmates in Jails in California and New York, as well as Prison inmates who have been transferred to county facilities to serve their terms for years in county jails in California. He has also overseen Correctional health car in locked units in Hospitals . Dr. Adler is the President-Elect of The American Correctional Health Services Association of California / Nevada, which represents all clinicians and administrators in Jails/Prisons in California and Nevada. He previously oversaw a County Hospital, County Nursing Home and ran a County Health Department and oversaw Correctional healthcare for the Westchester, New York Jail.

Litigation Support - Dr. Adler has defended Jails and Prisons in Southern California, Idaho, Texas, North Carolina, New York, Pennsylvania, etc. He has been involved in Plaintiff litigation in many states including against Rikers Island, NY and Cook County Jail. Dr. Adler still works as a full-time practicing physician and has helped attorneys and insurance companies in Emergency Medicine, Nursing Home Medicine, Public Health and Hospital Administration since 1985. Dr. Adler is available to review and consult on clinical Correctional/Jail/Prison cases for attorneys for both Plaintiff and Defense.

Services:

• COVID-19 Preparation & Response
• Screen Cases for Merit
• Review, Analyze and interpret Medical Records
• Provide Basic or Comprehensive Written Reports
• Interpret Standards of Care, Deviation and Adherences as they Relate to Correctional Health Care
• Develop Chronological Time Lines
• Policy and Procedure Development