Experts in healthcare data, regulations and economics

Selected by U.S. DOJ for expert work on healthcare regulations

Expert witness

HIPAA, HITECH Act, Affordable Care Act, medical coding and billing; industry best practices and guidelines

San Francisco / Silicon Valley engagement with VC and private equity

Health IT investor diligence, venture capital, private equity firms, health plans and providers, regulatory impacts

Boston expert witness, HIPAA Privacy and Security, HITECH Act safeguards

Anti-trust, computer assisted coding, ICD-10, clinical data economic impact

San Diego - mobile health solutions

Customer validation, strategic partners

Salt Lake City - Government health plan

ICD-10 Usual, customary and reasonable (UCR) cost of medical care

Miami - Medicare Advantage health plan

Risk adjustment, RAF scores, HEDIS® 5-Star Ratings

Healthcare IT investor diligence

St. Louis health plan, physician group, healthcare IT portfolio investor diligence in accountable care

Boston expert witness, HIPAA Privacy and Security, HITECH Act safeguards

Blog

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eMeasurement of Health Data for Quality, eCQM Adoption Issues

By | 2017-06-13T13:47:35+00:00 June 13th, 2017|eMeasurement, MACRA|

eMeasurement is the application of electronic health data for quality improvement has not yet been realized. Quality is the objective, but technology ability, education of clinician and administrative staff, and alignment of incentives must come first. Electronic clinical quality measurement (eCQM) is another label that CMS has placed on the eMeasurement initiative. eMeasurement will require [...]

Telehealth Visits Show Growth in Benefits for Insureds

By | 2017-05-30T23:08:32+00:00 May 30th, 2017|Telehealth|

Health plans are beginning to offer telemedicine services to their insureds that offer 24/7 access to online doctor visits.  For example, BlueCare is a benefit for most insureds of BlueShield of Louisiana.  As a result, online visits are intended to serve members with non-emergency minor illnesses such as colds (ICD-10 code R09.81 - Nasal congestion).  Also, [...]

Cybersecurity Expert Witness & WannaCry in Healthcare

By | 2017-05-22T21:12:38+00:00 May 23rd, 2017|Cybersecurity, Cybersecurity|

Cybersecurity Expert WitnessWhen WannaCry ransomeware harms the patients of health care providers or members of a health plan, litigation raises questions.  Were all measures taken to protect the plaintiff's information? Either plaintiff or defendant may retain a Cybersecurity expert witness.  First of all, WannaCry ransomware increased focus on securing health data.  Consequently, by raising the visibility of the [...]

American Health Care Act DOA. What Does it Mean for Medical Cost Litigation?

By | 2017-06-03T01:22:22+00:00 March 24th, 2017|Affordable Care Act, American Health Care Act|

American Health Care Act supporters, such as Paul Ryan, had to acknowledge that the Act was dead on arrival Friday.  Despite the fact that the Trump Administration presides over a Republican House and Senate, it became clear that the American Health Care Act will not pass.  The House of Representative members were released to go home for [...]

Secretary Tom Price Explains American Health Care Act

By | 2017-05-04T04:06:17+00:00 March 22nd, 2017|American Health Care Act, Tom Price|

On the eve of the house vote on the Trump Administration’s proposed health care law, the American Health Care Act of 2017 - H.R. 1628, HHS Secretary Tom Price appeared on Fox News on March 22, 2017 on Tucker Carlson Tonight.  According to Price:A. The American Health Care Act of 2017 (AHCA) is not just the AHCA, [...]

Rand Paul: Affordable Care Act Under Trump Administration “Legalize Low Cost Insurance”

By | 2017-11-28T05:01:54+00:00 January 24th, 2017|Affordable Care Act, Insurance Exchange, Trump|

Senator Rand Paul speaks regarding low cost insurance, affordable care act Senator Rand Paul (R) Kentucky was re-elected on November 8, 2016. In his interview on Fox News Channel Wednesday November 9, 2016 he re-iterated his statement that one of the first tasks for a Trump - led Republican Administration is to make it legal [...]

Trump Executive Order, ACA No Immediate Impact Promises Simplification and Freer Markets

By | 2017-05-04T04:06:17+00:00 January 24th, 2017|Accountable Care Organization, Affordable Care Act, Trump|

Michael Arrigo healthcare data, regulatory, economic and anti-trust expert witness in Federal State and Civil Courts on ACA, HIPAA, Healthcare costs in malpractice and personal injury, False Claims Act cases involving Medicare Advantage and Electronic Health Records. Contact now As promised, President Trump signed the first executive order regarding the Affordable Care Act. [...]

MACRA : “A” is for Access and “C” is for Children

By | 2017-05-04T04:06:17+00:00 October 27th, 2016|electronic health records, electronic medical records, HIPAA, HITECH, MACRA, MIPS, Uncategorized, Value Based Care|

MACRA Changes Health Care Economics with a Focus on ChildrenMACRA Background: A final rule released on Oct. 14, 2016 by the Centers for Medicare and Medicaid Services (CMS) details the final regulations for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the historic Medicare reform law that repealed the Sustainable Growth Rate (SGR) formula [...]

Value Based Insurance Design New Clinical Categories for MA Plans

By | 2017-05-04T04:06:18+00:00 October 4th, 2016|Affordable Care Act, Medicare Advantage, Value Based Care, Value-Based Insurance Design|

The Centers for Medicare & Medicaid Services (CMS) is announcing refinements to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. Beginning January 1, Value Based Insurance Design Model for Medicare Part C018, CMS will add and to the clinical categories for which participants may offer benefits. CMS will also make adjustments to existing clinical categories and [...]

Dual Eligibles for Medicare, Medicaid come under fire

By | 2017-05-04T04:06:18+00:00 August 19th, 2016|Affordable Care Act, Medicaid, Medicaid Expansion, Medicare, Obamacare|

Michael Arrigo expert witness in Federal State and Civil Courts on ACA, HIPAA, Healthcare costs in malpractice and personal injury, False Claims Act cases involving Medicare Advantage and Electronic Health Records.  CONTACT Dual Eligibles for Medicare, Medicaid cost too much. The administration that created the Patient Protection and Affordable Care Act with Medicaid expansion as [...]

Expert Witness for Future Medical Costs : Personal Injury, Medical Malpractice, Product Liability – ACA

By | 2017-05-04T04:06:18+00:00 July 12th, 2016|Accountable Care Organization, Affordable Care Act, CMS Value Based Purchasing, Expert Witness, HITECH, subrogation|

In our experience, one strategy is to work within the Superior Court or State Court level and then appeal to a higher court perhaps at the Federal level. Some courts have elected not to hear testimony regarding future care costs under the Affordable Care Act, only to find that it is the law of the land and now has an impact. There are also unintended consequences in product liability cases. Third party liability and subrogation may also be affected.