Managed Care Liability Expert Witnesses: 10

Research & Planning Consultants, LP (RPC) has been assisting clients with expert services for over 45 years, including consulting and expert witness testimony for personal injury, healthcare litigation, commercial litigation and Certificate of Need matters. RPC also offers a wide selection of health data. They have served clients across the U.S, from Alaska to Florida and from New England to California. 

A Complete Team of Damages Experts for Personal Injury Litigation

Research & Planning Consultants, LP provides the following services: 

• PERSONAL INJURY - RPC provides comprehensive damages analysis in personal injury litigation. Their expert team has life care planners, vocational evaluators, board-certified physicians, economists and neuropsychologists. 

Areas of Expertise include: Life Care Plans, Loss of Earning Capacity or Support, Present Value of Damages, Medical Bill Analysis, Chargemaster Analysis, Neuropsychological Testing & Traumatic Brain Injury, Vocational Evaluations, IMEs, Section 18.001, Prestanding ED Chargemaster Analysis

• COMMERCIAL LITIGATION- RPC has provided expert analysis on commercial litigation concerning many industries: chemicals, refining, forestry, waste management, pipelines, water resources, oil and gas EDP, fisheries, agriculture, electrical generating plants, transmission lines, telecommunications, and real estate development. Our special expertise in the healthcare industry has proven valuable to business litigators unfamiliar with this complex industry.

Areas of Expertise: Breach of Contract / Commercial Economic Damages, Construction Disputes, Litigation over Non-Competitive Agreements, Environmental Torts and Toxic Torts, Commercial Disparagement, Wrongful Termination

• HEALTHCARE LITIGATION - RPC offers economic, statistical, data and clinical analysis in a wide range of healthcare litigation. They have experience with payment disputes, qui tam litigation, physician-hospital disputes, practice valuations and construction litigation. 

Areas of Expertise: Qui Tam Healthcare Litigation, Medical Staff Disputes, Professional Liability, Payment Disputes, Health Facility Construction Disputes, Freestanding ED Chargemester Analysis

• CERTIFICATE OF NEED - RPC provides Certificate of Need (CON) planning services nationwide. We have over 35 years of experience developing regulatory strategy, preparing applications and testifying in public and administrative hearings.

Areas of Expertise: Satellite Hospitals, New Hospitals, Relocation and Transfer of Beds, Observation Beds, Geriatric Psychiatric Units, Children’s Hospitals, Comprehensive Inpatient Rehabilitation Units, Neonatal Intensive Care Units, Open Heart Surgery Services, Long Term Acute Care Units, Projects that exceed CON Capital Threshold Limits, Projects for Specifically Listed Services, Programs Requiring CON, Hospices, Senior Living Facilities

Ronald T. Luke, JD, PhD, is a principal consultant and President of RPC, LP. Ron joined RPC in 1976 and became its president and principal owner in 1979. He has consulted on projects for health care providers, managed care plans and public agencies in more than 25 states. He also serves as an expert witness in trials, administrative proceedings and legislative hearings.

Active in the Health Policy Arena, Dr. Luke has been accepted as an expert in Economics, Socioeconomic Impact Analysis, and Policy Analysis by state and federal courts, and state administrative agencies. The types of cases in which he has provided expert testimony include personal injury, contractual disputes, health care payment disputes, construction defects, utility construction permitting, and certificate of need. He has testified on health care matters including market structure, billing fraud and abuse, reasonableness of charges, medical staff credentialing, workers’ compensation fee guidelines, utilization review, physician contracts, and managed care contracts.

Kacy L. Turner, MS, CRC, CVE, CLCP, is a Certified Life Care Planner and Vocational Consultant with RPC. She has over 20 years of experience in Rehabilitation. Ms. Turner has experience writing life care plans for both plaintiff and defense clients. She has experience as a rehabilitation consultant in three states and has been qualified as a testifying expert in state and federal court.  

Ms. Turner has worked on cases in several states as well as the country of Trinidad. To determine the pre-injury and post-injury employability in personal injury cases, she provides vocational testing, transferable skills analysis, job requirements analysis, rehabilitation plans, and definition of reasonable accommodations under the American with Disabilities Act. She is a member of the International Association of Rehabilitation Professionals, the Texas Association of Rehabilitation Professionals and Providers of Services, and Vocational Evaluation and Career Assessment Professionals.

Brian Piper, PhD,  is an Economist with RPC specializing in Quantitative Analysis and Modelling. He works on a variety of cases including personal injury and certificate of need. He is experienced in data extraction, management, simulation, and analysis using STATA, SQL, ARC GIS and a variety of other programs. Dr. Piper has taught graduate classes in statistics and econometrics in both MBA and Ph.D. programs.

Dr. Piper is an experienced expert, providing testimony, reports, and affidavits on the issues of economic damages in personal injury litigation, healthcare litigation, False Claims Act litigation, and other commercial litigation. He has testified on behalf of plaintiffs and defendants. 

Dr. Piper specializes in the economics of healthcare. He has been retained by healthcare providers and insurers in payment disputes. He has analyzed the reasonableness of charges and expected payment for past and future medical services for providers, insurers, plaintiffs, and defendants. Besides work in litigation, Dr. Piper has provided analysis of Certificate of Need applications and the economic impacts of proposed legislation.

Milliman’s Tampa Office provides a variety of Health Insurance, Health Care services, and Pharma consulting services to law firms, health plans, insurance companies, HMO’s, Blue Cross/Blue Shield plans, hospitals and other providers, employers and government agencies. Stuart Rachlin and other staff are experienced actuaries and related consultants.  

We provide support to our clients with all types of health related services including Medicare Advantage and Prescription Drug plans (MAPD), Part D plans (PDP), ACA plans, 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, claim cost analysis, and fee schedule analysis.

These health care services are used in litigation relating to:

• Life care planning
• Contract development and fee schedule analysis
• Pricing & Underwriting
• Senior Services
• New benefit plan design

Mary Wickens, JD, CFE, CHC 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.

Cathy Ciolek, DPT, FAPTA, President of Living Well With Dementia, LLC, has over 30 years of experience as a Geriatric Physical Therapist. Dr. Ciolek is board certified as a Geriatric Clinical Specialist, a Certified Dementia Practitioner (CDP), and Certified Alzheimer’s Disease and Dementia Care Trainer (CADDCT) by the National Council of Certified Dementia Practitioners. 

Dr. Ciolek previously served as Regional Director for the Pennsylvania Restraint Reduction Initiative (PARRI),  providing education and consultation for issues related to well-being (falls, engagement, medication reduction) to nursing homes throughout the Commonwealth of Pennsylvania via a CMS grant. 

Prior to that, Dr. Ciolek served as assistant professor and director of clinical education for the University of Delaware, Department of Physical Therapy. She has practiced as a physical therapist in outpatient, SNF, home health and CCRC facilities over the course of her career.  She is a former Instructor/ Guest Lecturer/Lab Instructor at multiple universities including: Drexel University, Temple University, AT Still University/Arizona School of Health Sciences, Widener University, and Rocky Mountain University.

Dr. Ciolek delivers speaks and delivers seminars throughout the nation on topics including dementia, exercise for aging adults, falls and fall risk mitigation, and Person-Centered Care.

Geriatric Physical Therapy Thought Leader:

• President, Academy of Geriatric Physical Therapy (APTA Geriatrics)
• Past President, Delaware Physical Therapy Association (APTA Delaware)
• American Physical Therapy Association
• APTA Geriatrics
• APTA Delaware
• Catherine Worthingham Fellow of the American Physical Therapy Association Award

Litigation Support - Dr. Ciolek is available as an expert witness for attorneys representing plaintiff and defendant. Her services include medical record review, thorough reporting, depositions, and trial testimony as needed.

Areas of Expertise:

Falls Nursing Home Negligence Dementia Functional Decline Person-Centered Care Nursing Home Standard of Care Goals of Care Long Term Care Continuing Care Retirement Communities

Resident Rights Independent Living Transfers Restraints Safety Anti-psychotics Home Health Exercise Pain

View Dr. Cathy Ciolek's Consulting Profile.

Megan M. Hamilton, MS, CCC-SLP earned her Master of Science degree from Marquette University and holds a lean six sigma green belt from Purdue University as well as a Certificate of Clinical Competence from the American Speech Language and Hearing Association (ASHA).  Megan currently provides consultation to hospital speech language pathology and serves as a forensic medical SLP throughout the United States.  Megan has held positions as direct care provider, site manager, regional vice president, and division manager of clinical education for national rehabilitation providers in long term care, sub acute, and pediatric care.   She brings over 30 years of experience to her clients.  

Litigation Support - No healthcare provider can prevent aspiration and/or choking for all patients at all times, but all SLPs can be expected to practice within accepted standards of care.  Megan's exhaustive review of case materials can determine whether diagnosis, evaluation, recommendations and discharge determination were based upon sound clinical reasoning to mitigate adverse outcomes and facilitate improvement.  If standards of care were met, Megan provides evidence-based opinions of such.  When care failed to meet accepted standards, Megan can illustrate how the SLP provider deviated from standards.  She can assist in determining if substandard care contributed to negative outcomes including suspected choking event, aspiration, dehydration, health decline or death.  

Areas of Expertise:

Speech Therapy Speech Language Pathology Swallowing Oral Dysphagia Pharyngeal Dysphagia Esophageal Dysphagia TBI Expressive Language Receptive Language Parkinsons Choking Cognition Dehydration COVIDs impact on communication, dehydration and swallowing

Dementia Diet Texture Liquid Viscosity Aphasia Apraxia Dysarthria Developmental Disabilities Stroke CVA Aspiration Aspiration Pneumonia End of Life Nutrition Executive Skills Standards of Care

Megan has been an instructor in the areas of cognition, dysphagia / swallowing, end of life nutrition, and Medicare regulatory compliance. She has presented at conferences for the American Occupational Therapy Association and local Speech Language Hearing Associations as an employee of national Rehab companies.

The Lios Manhe (pronounced LIZ munee) mission is to be a trusted partner to plaintiff or defense by providing thorough analysis and independent opinions supported by science and based upon evidence collected.  
   

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.

Alan R. Smith, MD, RPh, FAAFP, is Board Certified as a Family Medicine Physician (American Board of Family Medicine) plus Board Certified by the American Board of Physicians and Surgeons. Along with a full-time, full-spectrum Family Medicine Practice, Dr. Smith is the Medical Director of Millard Care and Rehabilitation, a position he has held for over 30 years. 

Dr. Smith also serves the State of Utah as Chairman of the Utah Physician Licensing Board (2018 - Currently), and is a Fellow of the Federation of State Medical Boards. 

Litigation Support - Dr. Smith is retained as an Expert Witness with a focus on Family Medicine and Nursing Home Medical Malpractice. He has over 20 years of expert witness experience with approximately 100 cases reviewed, 25 depositions, and 10 court / arbitration testimonies. 

"I feel a responsibility to hold my fellow physicians, as well as myself, to the standard of care. I likewise feel a responsibility to stand and defend the truth when care of a physician is in question." - Alan R. Smith, MD

Areas of Expertise:

Obstetrics Surgical Obstetrics Inpatient and Outpatient Care Home Health Skilled Nursing Care Extended Nursing Care

Long Term Care / Hospice Care Endoscopy, Colonoscopy, and EGD Minor Surgery - Vasectomy Major Surgery - Hernia Repair, Endometrial Ablation, Tonsillectomy, Tympanostomy Tubes Emergency Department Care

Yolanda Anderson, RN, BSN, CEN, CLNC is a Registered Nurse and has been working in the Emergency Department for more than 25 years. A Certified Legal Nurse Consultant with a detail-oriented approach, Ms. Anderson is knowledgeable about all aspects of Hospital Care and Standards of Care for Physicians, Nurses and Ancillary Personnel.

Ms. Anderson's background experience includes work in the Emergency Department of Los Angeles County, USC Medical Center, a level I Trauma Center and 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 worked 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.

Ms. Anderson has been retained as an Expert 27 times. Her litigation support services include chart review for merit, chronologies, medical care research, Independent Medical Assessments, and more. Ms. Anderson's services are available to attorneys for both Plaintiff and Defense.

Areas of Expertise:

Emergency Department Care Inpatient Hospital Care Trauma, Cardiac, Neurological Emergency Adult, Pediatric, and Infant Care

Triage & Documentation Nursing Home Care Electronic Medical Records Worker's Compensation

View Yolanda Anderson's Consulting Profile.

Tanja Johnson, MSN, FNP-C, ENP-C, PMHNP-BC, LNC, is a Board-Certified Nurse Practitioner with over 25 years of experience in healthcare roles from Registered Nurse to Nurse Practitioner. Ms. Johnson earned her Master of Science in Nursing, becoming a board-certified Family Nurse Practitioner, a board-certified Emergency Medicine Nurse Practitioner, and then adding a PMHNP postgraduate degree. She has also obtained a Legal Nurse Consultant certificate to further facilitate her ability to contribute to the legal community.

Qualifications: Ms. Johnson has experience working in mental health, long-term care, hospice, medical/surgical care, and emergency medicine for a 20-year span as a registered nurse. The past 8 years have been spent practicing in emergency medicine as a nurse practitioner.

Areas of Expertise:

Hospital Care Medical / Surgical Care Emergency Medical Care Acute Care in Emergency / Urgent Setting Long-Term Patient Care

Hospice Care Inpatient Hospital Care Patient Complaints Medical Board Allegation Case Review Medical Terminology Translation

Litigation Support  - Ms. Johnson is available for both the defense and the plaintiff’s counsel providing a factual synthesis of any issue requiring the medical expertise of a medical care provider. She assists legal teams with navigating medical records and understanding terminology for legal cases such as medical malpractice, personal injury, insurance fraud, and worker’s compensation. Ms. Johnson provides knowledge and insight for care from nursing professionals, physician assistants, nurse practitioners, as well as physician practice.

Advanced Practice Nurse Consulting Services

Medical Expert Witness Hospital Case Review Lon Term Care Case Review Merit Review

Analyze Medical Records Literature Searches Synthesize Evidence Respond to State Medical or Nursing Board Allegations

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 is currently the expert consultant to the California Prison System for Covid litigation and the medical consultant to the judicial consent decree overseeing care in the Philadelphia Department of Prisons. He also served as the expert consultant to the ACLU for Covid in the Illinois Department of Corrections

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. He has been involved in Plaintiff litigation in many states including against Rikers Island, NY and Cook County Jail and is available to review and consult on clinical Correctional/Jail/Prison cases for attorneys for both Plaintiff and Defense.

Services:

• COVID-19 Preparation & Response
• Medical Oversight of Federal Consent Decrees
• 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