Expertise:

Audit
Medical Standards of Care
Geriatrics and Nursing Home Care Standards
Health Insurance
Health Insurer-Provider Relations
Managed Healthcare (HMO, PPO)
TPA (Third Party Administrator)
National Accreditation Guidelines
Medicare / Medicaid
Federal Employees Health Benefits Program
CDH (Consumer Drive Health Plans)
ERISA, COBRA, EMTALA, HIPAA
Physician / Hospital Joint Ventures
Qui Tam and False Claims Act

Litigation Issues:

Medical Malpractice, Medical Management, Physician and Hospital Billing and Collection, Industry Standards Adherence, Utilization Review, Medicare / Medicaid, Hospital and Physician Provider Credentialing and Contracting, Ostensible Agency, Provider and Member Communications, Patient Benefits Determinations and Grievance and Appeal Procedures, including External Review, Financial Reimbursement Models, Compensation and Capitation, Referral and Certification, Subrogation and Third Pary Recovery, Due Process Requirements, Class Action, Case Management