Medicare Expert Witnesses

California

Marketing, Management - Bio-similar drugs, Biotech & Pharma Marketing, Operations, Branded Promotion, CNS Products, Medicare, Oncology Products, Pharma Commercialization, Pharmaceutical Contracting & Pricing, Pharmaceutical Launch, Pharma Marketing, Pharma Sales, Specialty Pharma, DTC, Commercially Reasonable Efforts, CRE

Mr. Hosier is a strategic advisor to the life sciences industry drawing on more then 26 years of sales, marketing and managed markets experience in commercial healthcare organizations. He has provided insights to small molecule & biotechnology companies across multiple therapeutic areas but has maintained a heavy concentration in oncology and specialty pharmaceuticals. He has led brand launch; corporate, franchise, and strategic brand planning; commercial integration; organizational design; and operational effectiveness from multiple perspectives (as the client, as the independent consultant, and as an agency lead). Mr. Hosier’s firm has architected the launch of rare disease and oncology business units for multiple pharmaceutical clients (large and small); led development of the managed markets, trade, and distribution strategy for the launch of new chemical entities (NCEs) and 505(b)2 assets for various organizations; advised on commercially reasonable effort (CRE); and provide...

Mill Valley, California

Psychiatry, Geriatric Psychiatry - Contested wills and trusts, Testamentary capacity, Undue Influence, Geriatric Psychiatry, Elders & Elderly, Dementia, Alzheimer's Disease, Nursing Homes, Assisted Living, Medicare, Geriatric decision making capacity competency, Medical Documentation and Coding, Depression, Anxiety, Stress, Psychosis

Providing legal and forensic consultation on legal issues pertaining to the elderly and their mental, emotional, behavioral and cognitive functioning, including contested inheritance, undue influence and financial elder abuse, and dementia and related issues in nursing homes, memory care and assisted living facilities. Clinical Professor (Voluntary), Psychiatry, University of California San Francisco; Psychiatric Consultant, San Francisco Towers life care community 2021- Present. Consultant in Geriatric Psychiatry, San Francisco Veterans Administration Medical Center 2021 - 2023. Previously, Director of Psychiatry, Jewish Home of San Francisco, 2010 – 2020. Previously in private practice of Adult and Geriatric Psychiatry, 1977 – 2010, in Miami and Miami Beach, Florida. Board Certified, Geriatric Psychiatry and General Psychiatry, by the American Board of Psychiatry and Neurology. Distinguished Life Fellow, American Psychiatric Association. Distinguished Fellow, American A...

Oceanside, California

Geriatrics, Nursing Homes - Nursing Home - Skilled Nursing Facility, Hospice - End-of-Life Care, Palliative Care, Home Health, Assisted Living, Regulatory, Decubitus, Pressure Ulcers, Falls, Dementia - Alzheimer's, Medicare, Medicaid, Managed Care - HMO, Life Care Planning, Personal Injury, Family Medicine, Addiction Medicine

Experienced Expert, 250+ depositions, 25+ trials. Speedy and Objective Records Reviews (plaintiff/defense); Standard of Care, Causation and Damages Opinions, including Life Expectancy and Future Care Costs, Regulatory Actions; Comprehensive Report Writing. References Available on Request. In clinical practice of post-acute and long-term care medicine, Geriatrics & Hospice in San Diego area since 1992; Chief Medical Officer, Mariner Health Care (nursing facility management company); Chief Medical Officer, Beecan Health; Delegate, AMA and California Medical Association House of Delegates; Chair, CMA Council on Ethical, Legal & Judicial Affairs; Clinical Faculty UCSD School of Medicine and Family Medicine Dept. Adjunct faculty, Case Western Reserve University; Affiliate Faculty, California State University's Institute for Palliative Care (San Marcos), Past President of CALTCM, Past President of AMDA--The Society for Post-Acute and Long-Term Care Medicine (www.paltc.org, formerly kn...

San Diego, California

Nursing Home Administration, Long Term Care - LNHA, MBA, California, San Diego, Healthcare administration, Skilled Nursing Facility Management, CMS Survey Compliance, Patient Care Quality Improvement, Post-Acute Care Services, Dementia, 5-Star Rating, Regulatory Compliance, Medicare, Expert, Healthcare Leadership, Nursing Home Expert

Robert D. Zitsman, LNHA, MBA, NHA, has over thirty-five years of experience in healthcare administration, focusing on promoting excellent, evidence-based patient care outcomes and creating positive experiences for patients, residents, families, and staff. His extensive career spans the continuum of care from critical care to long-term care, including inpatient acute rehab, post-acute rehab, dementia care, assisted living, and entry fee model continuing care retirement communities (CCRCs). Robert has consistently maintained substantial compliance with CMS surveys for over twenty years. Currently, Robert serves as the Administrator at Community Memorial Hospital-Ojai’s Continuing Care Center, a 75-bed skilled nursing facility. He has held numerous leadership positions, including Interim Administrator at Community Hospital of the Monterey Peninsula and Administrator at Escondido Post Acute Rehab, overseeing operations at facilities with up to 180 beds. His role at Life Care Services a...

Orlando, Florida

Medical Coding, Medical Billing - CPC, CPMA, COC, CCS, medical coding, medical billing, medical auditing, Qui tam, AAPC, CIA, IRO, Medicare, Inspector General

Ms. Diamond is an experienced coding, billing, and auditing professional who is available for consultation in medical practice auditing, billing, coding, compliance, litigation, reimbursement, and revenue cycle issues when requested by medical providers, their management, or their legal counsel. She is a Certified Professional Coder (CPC) and Certified Outpatient Coder (COC) by the American Association of Professional Coders (AAPC), with her initial certifications over 30 years ago. She has served as a member of the AAPC National Advisory Board, has been a Fellow of the AAPC, and has served as President of the Greater Orlando Chapter of AAPC. She is a Certified Professional Medical Auditor (CPMA) by the AAPC. For 18 years, she led billing and coding for a university multi-specialty medical practice of over 400 physicians. She has 20 years of experience as a medical auditor with a company that provided medical auditing services for medical practices, hospitals, and commercial me...

Melbourne, Florida

Medical Coding, Ophthalmology - Surgeon, Coder, Auditor, Fair and Reasonable Value, Medical Coding, Physician Coding, Ophthalmology Coding, Optometry Coding, Reimbursement, Eye Care, Coding, Medicare, Healthcare Fraud, Audits, False Claims Act, National Correct Coding Initiative, Bundling

ABOUT: Highly experienced expert witness with 100+ cases in medical coding, reimbursement, and compliance across the entire medical spectrum, providing services for both plaintiff and defense. Board-certified practicing physician and surgeon, Certified Coding Specialist (Physician-based), and Certified Professional Medical Auditor. Awarded graduate of Cornell University’s College of Engineering (B.S.) and the University of Michigan Medical School (M.D.), with postgraduate specialty training at Johns Hopkins Hospital and the University of California, San Francisco. Master-level graduate (M.B.A.) of the University of Central Florida, College of Business Administration. Chairman of the Ophthalmology Section at Holmes Regional Medical Center in Melbourne, Florida. Assistant professor at the University of Central Florida, College of Medicine. Extensive committee involvement, including American Medical Association’s CPT Advisory Committee and the Florida Medicare Carrier Advisory Com...

West New York, New Jersey

Marketing, Management - Bio-similar drugs, Biotech & Pharma Marketing, Operations, Branded Promotion, CNS Products, Medicare, Oncology Products, Pharma Commercialization, Pharmaceutical Contracting & Pricing, Pharmaceutical Launch, Pharma Marketing, Pharma Sales, Specialty Pharma, DTC, Commercially Reasonable Efforts, CRE

Mr. Hosier is a strategic advisor to the life sciences industry drawing on more then 26 years of sales, marketing and managed markets experience in commercial healthcare organizations. He has provided insights to small molecule & biotechnology companies across multiple therapeutic areas but has maintained a heavy concentration in oncology and specialty pharmaceuticals. He has led brand launch; corporate, franchise, and strategic brand planning; commercial integration; organizational design; and operational effectiveness from multiple perspectives (as the client, as the independent consultant, and as an agency lead). Mr. Hosier’s firm has architected the launch of rare disease and oncology business units for multiple pharmaceutical clients (large and small); led development of the managed markets, trade, and distribution strategy for the launch of new chemical entities (NCEs) and 505(b)2 assets for various organizations; advised on commercially reasonable effort (CRE); and provide...

New York

Marketing, Management - Bio-similar drugs, Biotech & Pharma Marketing, Operations, Branded Promotion, CNS Products, Medicare, Oncology Products, Pharma Commercialization, Pharmaceutical Contracting & Pricing, Pharmaceutical Launch, Pharma Marketing, Pharma Sales, Specialty Pharma, DTC, Commercially Reasonable Efforts, CRE

Mr. Hosier is a strategic advisor to the life sciences industry drawing on more then 26 years of sales, marketing and managed markets experience in commercial healthcare organizations. He has provided insights to small molecule & biotechnology companies across multiple therapeutic areas but has maintained a heavy concentration in oncology and specialty pharmaceuticals. He has led brand launch; corporate, franchise, and strategic brand planning; commercial integration; organizational design; and operational effectiveness from multiple perspectives (as the client, as the independent consultant, and as an agency lead). Mr. Hosier’s firm has architected the launch of rare disease and oncology business units for multiple pharmaceutical clients (large and small); led development of the managed markets, trade, and distribution strategy for the launch of new chemical entities (NCEs) and 505(b)2 assets for various organizations; advised on commercially reasonable effort (CRE); and provide...

Pennsylvania

Marketing, Management - Bio-similar drugs, Biotech & Pharma Marketing, Operations, Branded Promotion, CNS Products, Medicare, Oncology Products, Pharma Commercialization, Pharmaceutical Contracting & Pricing, Pharmaceutical Launch, Pharma Marketing, Pharma Sales, Specialty Pharma, DTC, Commercially Reasonable Efforts, CRE

Mr. Hosier is a strategic advisor to the life sciences industry drawing on more then 26 years of sales, marketing and managed markets experience in commercial healthcare organizations. He has provided insights to small molecule & biotechnology companies across multiple therapeutic areas but has maintained a heavy concentration in oncology and specialty pharmaceuticals. He has led brand launch; corporate, franchise, and strategic brand planning; commercial integration; organizational design; and operational effectiveness from multiple perspectives (as the client, as the independent consultant, and as an agency lead). Mr. Hosier’s firm has architected the launch of rare disease and oncology business units for multiple pharmaceutical clients (large and small); led development of the managed markets, trade, and distribution strategy for the launch of new chemical entities (NCEs) and 505(b)2 assets for various organizations; advised on commercially reasonable effort (CRE); and provide...

Fort Worth, Texas

Medical Billing, Medical Coding - Qui Tam, Health Insurance Fraud, Health Insurance Abuse, Medicare, Medicare Fraud, Medicare Abuse, Medical Policy, Medical Necessity in Medicare, Medicare LCDs, Medicare NCDs, Medicare Coding, Medicare Billing, Health Insurance Coding, Upcoding, Medical Devices, New Medical Technology

Completed SEAK Expert Witness Training. Experience working on 4 large qui tam cases. Retired Captain (O-6) United States Navy. Board Certified General Surgeon. Partner in Healthcare Compliance Management, LLC, a consulting firm incorporated in Texas. Dr. Alexander and his partners established HCM in early 2002 and since that time he has been involved in numerous healthcare compliance consulting projects for major pharmaceutical and medical device manufacturers, large and small hospitals, cancer centers, large and small physician groups, other consulting entities as a special consultant, and legal firms (both as a consultant and as an expert witness).

San Antonio, Texas

Preventive Medicine, Public Health - Health Insurance, Utilization Management, Government Health Contracts, Health Quality, Outbreak, Communicable Diseases, TRICARE, Medicare, Medicaid, HIV, LGBT care, Immigrant Care, Non-profit or indigent care, Correctional facility care, Appeals, Academic health care, Population health, Tuberculosis

Senior C-Suite Executive Physician• Clinical expert in population health management and disease prevention.• Health Plan/Complex Health System• Corporate/Government/Academic• Non-profit Leadership/Boards• Government Relations• Outbreak/Contamination Expert• Procurement/Business Development• Community Advocacy/Engagement• Clinical Quality Process Improvement• Public Health Consulting• Disease Prevention/ HEDIS Attainment• Utilization/Case/Disease Management• Clinical Network Credentialing/Safety• Mentor Inclusion and Diversity• Accreditation, Certification• Public Spokesperson/ Media Trained• Social Determinants of Health• Analytics/Metrics/Deliverables• World Class Employee Satisfaction• Expert Testimony in Public Health, Preventive Medicine, Population Health, Health Insurance and Healthcare. BC Preventive Medicine/BE Family Medicine Physician• Clinical expertise and leadership in public health, population health management and clinical quality.• Experience in large multidisciplin...

DALLAS, Texas

Medical Billing, Medical Coding - Medical Bill Review, Reasonableness of Medical Bills, Forensic Bill Review, Medical Cost Analysis, Expert Witness for Deposition/ Trial, Usual, Customary, Reasonable (UCR) fee analyses, Geographic Specific Provider market comparisons, Medicare, Medicaid, Major Insurance comps