False Claims Act Expert Witnesses

New Britain, Connecticut

Medical Billing, Medical Coding - Medical Records Review, Provider Documentation, Medicaid/Medicare, State Regulations/Statutes, Federal Regulations/Statutes, Regulatory Compliance, Healthcare Fraud Investigation, Data Analysis, Data Mining, Payment Integrity, False Claims Act, Fraud Waste and Abuse, Provider Billing Verification

I provide expert witness services in healthcare billing, coding, and clinical documentation, supported by over 19 years of industry experience across provider, payer, and compliance environments. My work focuses on the evaluation of medical records, coding accuracy, documentation integrity, and regulatory compliance, including alignment with federal, state and commercial payer requirements. I hold a Master of Legal Studies in Health Law, which strengthens my ability to analyze healthcare documentation within legal and regulatory frameworks and to clearly articulate findings in both written reports and testimony. I maintain multiple nationally recognized certifications, including Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Documentation Expert Outpatient (CDEO), Certified in Healthcare Compliance (CHC), Certified Fraud Examiner (CFE), and Registered Health Information Administrator (RHIA). My expertise includes auditing evaluation an...

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...

Gainesville, Georgia

Hospice and Palliative Care, Geriatrics - Hospice Fraud, Terminality, Medical Necessity, Capacity Assessments, Testamentary Capacity, Undue Influence, Standards of Care, Palliative Medicine, Geriatrics, Medicare Compliance, False Claims Act, Informed Consent, Patient Autonomy, Goals of Care, Surrogate Decision-making, Dementia, Terminal Prognosis, Advance Directives

As a board-certified physician in Hospice and Palliative Medicine, I have been at the forefront of the field for over two decades. In 2008, I founded and developed WellStar Health System's Palliative Care program, establishing the clinical protocols, ethical frameworks, and documentation standards at a time when only one other program (Emory) existed in the region. Having served as a hospice medical director before Face-to-Face (F2F) documentation was a regulatory requirement, I have experienced the full evolution of hospice oversight. This foundational experience provides me with a unique and historically grounded perspective on the National Standard of Care. I bring extensive clinical experience in leading high-stakes goals-of-care conversations and thoroughly documenting patient wishes. I have firsthand experience with the nuances of family disagreements and the challenges of evaluating the validity of Advance Directives. My forensic expertise lies in determining whether clinica...

Federal Way, Washington

Financial, Investigation - Fraud, Bank Fraud, SBA Fraud, Loan Fraud, Elder Abuse, Government Contracting Fraud, Asset Tracing, Litigation Support, Consulting, Qui Tam, Investment Fraud, Investigation-Case Review, White Collar Crimes, Whistleblower, Criminal Defense, Civil Fraud, False Claims Act, False Claims, Embezzlement, Bankruptcy Fraud

Over 26 years as a federal agent conducting complex white collar investigations involving bank and loan fraud, SBA Program Fraud, bankruptcy fraud, contract fraud, money laundering, mortgage fraud, and real estate fraud. For the last 6 years, as a consultant, Certified Fraud Examiner and Private Investigator (WA), Kari's focus has been on these same specialties, with additional work in investment fraud, elder financial exploitation cases, divorce cases, and finding assets.