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

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 

Erin O’Callaghan BS, MA, JD, LPC, CRC, NCC, CLCP, is a member of the International Association of Rehabilitation Professionals, International Academy of Life Care Planners, Michigan Rehabilitation Association, Michigan Bar Association and the American Board of Vocational Experts.

Ms. O’Callaghan has worked diligently for 15 years as a rehabilitation professional providing the highest standards of professional ethics. She has extensive occupational knowledge of the current labor market and how limitations may impact employability and earnings capacity. She provides consultation services in the areas of: 

Life Care Planning - In depth analysis of medical records, injuries, relevant guidelines for case facts and future care. Application of standardized methodology in the preparation of a Life Care Plan. Written and /or verbal consultation with members of treatment team and evaluators for use in the development of a lifelong plan of care. 

Wage Earning Capacity - Evaluation of transferable skills, labor market information, and geographical employment opportunities subsequent to an injury or disability to determine employability and/or loss of earnings capacity. 

Vocational Rehabilitation - Full range of vocational rehabilitation services including vocational counseling, job seeking skills training, rehabilitation, and adjustment to disability counseling. Lien Dispute - Assessment of lien and costs assicated with litigated claims versus pre-existing medical conditions. www.experts.com

View Erin O’Callaghan's Expert Witness Profile.

Lindsay Malzone is the Medicare Consultant for MedicareFAQ. She has worked in the Medicare industry since 2017 and is featured in many publications as well as writing Medicare focused columns for other publications.

Ms. Malzone is part of the Medicare Marketing Association, the Medicare Supplement Insurance Professionals group, and the DecisionHealth – Medical Practice & Hospital Group. You can also find her over on Medicare Channel on YouTube and as well as contributing to their  Medicare Community on Facebook.

The Burroughs Healthcare Consulting Network specializes in all aspects of Physician, Medical Staff, Management, and Governance Challenges. President and CEO, Jonathan H. Burroughs, MD, MBA, FACHE, FAAPL, works with some of the nation’s top healthcare consulting organizations to provide ‘best practice’ solutions and training to healthcare organizations throughout the country in the areas of:

Dr. Burroughs serves on the national faculty of the American College of Healthcare Executives and the American Association for Physician Leadership (formerly the American College of Physician Executives), where he has been consistently rated as one of their top speakers and educators. He and Dr. David Nash were recently awarded a development grant by the American College of Healthcare Executives (ACHE) to develop a twelve hour national program to address population health and the disruptive innovative business models necessary to support it. He is the author or coauthor of the following books:

Dr. Burroughs is the author or coauthor of the following books: Essential Operational Components for High Performing Healthcare Enterprises (2018, awarded the James A. Hamilton Award for outstanding healthcare management book of the year in 2020 by the American College of Healthcare Executives); Redesign the Medical Staff Model-A Collaborative Approach (published by Health Administration Press, January, 2015, awarded the James A. Hamilton Award for outstanding healthcare management book of the year by the American College of Healthcare Executives in 2016); The Complete Guide to FPPE (2012); Medical Staff Leadership Essentials (2011); Engage and Align the Medical Staff and Hospital Management: Expert Strategies and Field Tested Tools (2010); A Practical Guide to Managing Disruptive and Impaired Physicians (2010); The Top 40 Medical Staff Policies and Procedures, Fourth Edition (2010); Emergency Department On-Call Strategies: Solutions for Physician-Hospital Alignment (2009); and Peer Review Best Practices: Case Studies and Lessons Learned (2008). 

Dr. Burroughs is a former Senior Consultant and Director of Education Services for The Greeley Company where he was rated as one of their top healthcare consultants and educators over an eight year period. He is also a past medical staff president, past president of the New Hampshire chapter of the American College of Emergency Physicians, and served as an emergency department medical director. As a member of the governing board of Memorial Hospital in New Hampshire, he chaired the ethics, succession planning, and bylaws committees and sat on the joint conference, strategic planning, and medical executive committees. He previously served as a member of the clinical faculty of Dartmouth Medical School, where his research interests included introducing EMT defibrillation and automatic defibrillation into the field.

View Dr. Burroughs' Expert Witness Profile.