State and federal testimony on Usual Customary and Reasonable cost of care, Affordable Care Act; value-based care / risk-adjustment in Medicare Part C; ACOs; HIPAA Privacy and Security; medical coding, billing, and auditing; qualified health plans; insurance fraud, meaningful use of EHRs; anti–trust market analysis
Value-based care, MACRA, MIPS. Represented payors and providers in meaningful use audit defense, reasonable value for medical care (UCR cost), billing disputes, damages phase of professional liability using Affordable Care Act or fee–for–service cost, Clinical Documentation Improvement and analytics.
M&A diligence in Health IT including cloud computing, HIPAA disclosures, EHR electronic claims processing, mobile health, Software as a Service (SaaS), single sign on, claims systems, EDI support for Medicare administrative contractors, and more. Visibility into $4 billion in M&A transactions to date.