Partner

• Aug 2014 - Present

Healthcare attorney, representing all providers, small and large, in relation to fraud, waste, and abuse matters, RAC and ZPIC audits, reimbursement and coding, compliance and related regulatory matters. Texas Medical Liability Trust (TMLT) approved attorney Healthcare attorney, representing all providers, small and large, in relation to fraud, waste, and abuse matters, RAC and ZPIC audits, reimbursement and coding, compliance and related regulatory matters. Texas Medical Liability Trust (TMLT) approved attorney

Attorney

• Jun 2014 - Present

Highly experienced healthcare attorney and compliance professional who represents the entire spectrum of healthcare providers, large and small, in healthcare, fraud and abuse, privacy and compliance related matters. Highly experienced healthcare attorney and compliance professional who represents the entire spectrum of healthcare providers, large and small, in healthcare, fraud and abuse, privacy and compliance related matters.

Director of Compliance / Privacy Officer

• Jan 2011 - Jun 2014

-- Implement and manage Corporate Integrity Agreement, including developing and implementing training and ensuring timely completion of training, drafting and updating policies and procedures, conducting various audits, managing independent review organization audit, managing sanctions screening process, conducting ride-alongs, resolve reports of potential improper actions/behavior, drafting annual and periodic reports to the federal government. Managed Focus Arrangements through Needs Assessment process and annual HCP consulting services master plan, in accordance with AdvaMed guidelines. Developed design document and selected and managed vendor to programming of new Focus Arrangements database. -- Served as interim Chief Compliance Officer, drafting and producing materials for Board of Directors and reporting to the same. Participated in Executive Compliance Committee. -- Serve as Privacy Officer, developing and updating privacy policies, investigating and resolving potential breaches, implementing risk assessment process. Updated Business Associate Agreements and Notice of Privacy Practices to comply with Omnibus Rule. -- Provided direction and support for Physician Payments Sunshine Act database selection and collection and reporting of relevant data. --Implemented and managed data base of international third party, distributor, and HCP consultant compliance and documentation for FCPA compliance. Conducted due diligence and screening of third parties and HCP consultants. Managed Needs Assessment process in compliance with Eucomed guidelines. Manage European Compliance Committee. Drafted periodic reports to DOJ and SEC in relation to FCPA DPA and Consent Decree. -- Manage 3 employees. Show less

Attorney

• 2008 - Jan 2011

Represent, advise and defend clients in health care law, health care compliance, privacy and general corporate matters, including healthcare regulatory, audits and appeals, and corporate compliance issues. Drafted legal agreements and corporate documents. Represent, advise and defend clients in health care law, health care compliance, privacy and general corporate matters, including healthcare regulatory, audits and appeals, and corporate compliance issues. Drafted legal agreements and corporate documents.

Attorney

• 2007 - 2008

Focusing on health care, regulatory, health insurance and general corporate matters. Resolved insurance companies' failures to pay health care providers' valid claims. Focusing on health care, regulatory, health insurance and general corporate matters. Resolved insurance companies' failures to pay health care providers' valid claims.

Sr. Director, Compliance Dept., Policies & Procedures

• 2006 - 2007

Sr. Director, Compliance Reporting & Monitoring

• 2003 - 2006

Attorney

• 2002 - 2003

Attorney

• Sep 1995 - Oct 2002

Nationwide health care law, regulatory and compliance practice, representing DME companies, compounding pharmacies, hospitals, physicians, and long-term care facilities on health care law, compliance and regulatory issues, including payer reimbursement disputes, audits, requests for overpayments, ALJ hearings and appeals. Won significant reversals of unfavorable carrier determinations at Fair Hearing and ALJ levels. -- Developed and implemented corporate compliance programs and implemented of Corporate Integrity Agreements. -- Evaluated relationships and transactions for fraud and abuse / anti-kickback / Stark law compliance. Addressed supplier and provider number issues, including CHOWs. -- Worked extensively with National Supplier Clearinghouse, fiscal intermediaries (now called MACs), carriers (now called DMACs), OIG and CMS, and private insurance companies. -- Obtained favorable OIG Advisory Opinion for client. Show less