Medicaid - Medicare Consultants: 7

Elliott M. Stein, MD is Board Certified by the American Board of Psychiatry and Neurology in General Psychiatry (October, 1979), and in Geriatric Psychiatry (April, 1991; Re-Certified, December, 2001, and in April, 2011). Caring for the elderly for over 40 years, Dr. Stein has received numerous honors and awards for his contribution to his field. Dr. Stein is a Clinical Professor in the Department of Psychiatry at the University of California, San Francisco, School of Medicine. He is a Distinguished Life Fellow of the American Psychiatric Association and a Distinguished Fellow of the American Association for Geriatric Psychiatry.

For 33 years, Dr. Stein was in the Private Practice of Geriatric Psychiatry in Miami and Miami Beach, Florida. His experience includes working with the elderly in various settings, including having been Medical Director for the Community Mental Health Center of Miami Beach, Medical Director of an Inpatient Geriatric Psychiatry program, and Medical Director of an Inpatient Mood Disorder program, as well as consulting at Nursing Homes, Assisted Living and other facilities. Dr. Stein was the Director of Psychiatry at the Jewish Home of San Francisco from 2010-2020, and the Medical Director of their Geriatric Psychiatry Hospital. He has treated older individuals, typically people who have complex combination of psychiatric and medical problems.

Dr. Stein has been a Member of the Task Force on Testamentary Capacity and Undue Influence, for the International PsychoGeriatric Association.  He is also the author/co-author of teaching and professional materials, including books and book chapters, and articles in the professional literature.

Consulting Specialties:

• Contested Wills and Trusts
• Testamentary Capacity, Undue Influence, Insane Delusions
• Geriatric Competence
• Dementia and Delirium, Alzheimer’s Disease
• Geriatric Psychiatry Evaluation and Treatment, Psychiatric Medication, Psychotherapeutic Issues
• Depression and Anxiety Disorders
• Relationship Problems between the Elderly and their Adult Children
• Aging and Mental Disorders
• Geriatric Psychiatry issues concerning Hospitals, Nursing Homes, Independent and Assisted Living Facilities
• Medicare Psychiatric Services Coding and Documentation

View Dr. Stein's Expert Witness Profile.

Michael Arrigo is the Managing Partner, Healthcare Practice for No World Borders, and is a testifying expert witness.  He works with health systems, health IT companies, and health plans. Recent retentions by the U.S. Department of Justice (DOJ) include drug pricing, patent infringement, medical coding, and billing and Qui Tam False Claims Act and fraud case specialties. 

Mr. Arrigo 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)

Please click the link below for a current CV.

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

William (Bill) C. Mohlenbrock, MD, FACS, is a nationally recognized expert in the assessment of hospital quality having developed systems to quantify the major metrics of hospital quality. The defense of a hospital involved with an allegation of malpractice might find it very useful to have three years of risk-adjusted data, encompassing all the major metrics of quality, as an adjunct to the defense against the allegation. He provides consulting services to hospitals including:

• Hospital Quality of Care
• Mortality Rates
• Risk-adjusted Clinical Information System for Monitoring and Improving Quality and Cost-efficient Inpatient Care

To address Medicare's Prospective Payment System in 1983, Dr. Mohlenbrock founded a technology and consulting company, Verras, and developed the Acuity Index Method, a risk-adjusted clinical information system for monitoring and improving quality and cost-efficient inpatient care. Verras received the American Hospital Association’s exclusive endorsement in 2015. His experience in the area of pay-for-performance led to the creation of Verras’ Medical Value Index (MVI), which is a patented, objective means to quantify value of hospitals’ outcomes and assist providers with the distribution of hospitals’ and physicians’ payments for Global and bundled-payment models.

Comprehensive Quality Data used to Defend Hospitals for Med Mal

Dr. Mohlenbrock has practiced General Orthopedics and Trauma Care, including total joint and arthroscopy surgeries and sports medicine and related injuries for many years at Scripps Memorial Hospital in La Jolla, California. He is senior physician in a group of 8 orthopedic surgeons and 2 Physician Assistants.

Dr. Mohlenbrock is a noted lecturer and has published numerous articles on measuring and improving the quality and cost efficiency of medical care. His extensive teaching in these areas has made him comfortable conveying complex problems in public forums, including Fox News.

View Dr. Mohlenbrock's Expert Witness Profile.

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.

HLN offers Peer-reviewed methodologies and Appellate court proven testimony by experienced professionals who have provided consulting services and conducted audits and investigations for hundreds of hospitals, physicians and other healthcare providers nationwide. HLN's experts have provided expert testimony in administrative and regulatory proceedings, as well as in state and federal courts for civil and criminal cases, for plaintiffs and defendants.

HLN provides experts in: medical billing, reasonableness of charges, reasonable value of medical services, Medicare & Medicaid reimbursement and compliance, clinical documentation, medical record coding, economic damages, insurance disputes, lost profits and false claims. HLN's founder co-authored two editions of the AMA's best selling Mastering the Reimbursement Process book. 

HLN's Consultants include:

• Certified Public Accountants (CPA) 
• Certified Coding Specialists (CCS and CCS-P)
• Certified in Financial Forensics (CFF) 
• Certified in Healthcare Compliance (CHC) 
• Certified Fraud Examiner (CFE) 
• Certified Healthcare Chart Auditor (CHCA) 
• Certified Professional Coder (CPC and CPC-H) 
• Licensed Insurance Agents
  
• RNs, MDs, DOs and DCs
• Financial Analysts
• Statisticians 

Excel Impact was founded in 2013 and has evolved into a leading performance-driven Customer Acquisition firm with a centralized focus on Insurance. 

Excel Impact solves the problem of buying great insurance by connecting consumers to great insurance products through an opti-channel routing experience, placing the needs of the consumer at the forefront of all decisions. To do this, Excel Impact uses predictive modeling comprised of data science (DS), machine learning (ML), and artificial intelligence (AI) to match consumers with the most optimal products and services to best meet their needs.

Craig Sturgill is currently the co-founder and chief strategy officer at Excel Impact. He is well-known within the insurance industry for his innovative thinking and strategic approach, specializing in lead generation and internet advertising for multiple products including Medicare, Health, Home, Auto, and Final Expense life insurance. 

Mr. Sturgill is a leader in entrepreneurship, having started his own business while still in high school and growing not just one, but three full-fledged companies by the ripe age of 27.

Products:

• Leads: High intent consumers who have submitted a real-time request for insurance quotes on our website.
• Calls: Rather than completing a quote request form, some consumers prefer to speak with a live agent via phone.
• Clicks: We offer advertising solutions if you are looking to drive targeted traffic to your website.

Verticals:

• Medicare: Medicare Supplement, Medicare Advantage, and more.
• Health: Affordable Care Act, Short Term, Subsidy, Non-Subsidy, Medicaid, and more.
• Life: Term Life, Whole Life, Final Expense, and more.

Steven Elson, PhD, has 35 years in executive leadership of not-for-profit organizations providing Mental Health and Residential Services to Children and Youth with complex trauma and/or presenting challenging and disruptive behavioral/emotional issues. 

Dr. Elson has overseen services provided to more than 50,000 vulnerable children and youth and their families in a highly regulated, compliance driven industry. Payors have included both public (Medicaid) and private (commercial insurance and private pay) and involve multiple and complex funding streams. Significant growth and new lines of business attained in all leadership positions/organizations while achieving state and national recognition for training and service excellence.  As CEO Dr. Elson launched consultation and training services directly impacted organizations in 15 states and seven foreign countries. He is actively involved in virtually all significant public policy initiatives affecting child welfare and mental health in California. Industry leadership includes Board membership on five state-wide and one national association. Dr. Elson has been elected and served a term as President in each of the six associations. 

Begun in 2020, independent consultation has included work with five California nonprofits ranging in size from $2 million to $60 million and a state-wide industry association and serving as Interim Executive Director with one organization undergoing leadership transitiion. 

Consulting Services

• Help non-profit agencies that work in the child and adolescent mental health space to increase financial stability
• Develop new lines of business including contracts with commercial insurance companies
• Enhance regulatory compliance
• Meet accreditation standards
• Improve clinical / service performance
• Strengthen Board knowledge and skills
• Create strategies / plans in sync with community needs and market trends

View Dr. Steven Elson's Expert Witness Profile.