Qui Tam Expert Witnesses
Qui tam expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on qui tam. The qui tam expert witness listings on this page are typically from fields/areas of expertise such as: Insurance, Medical Billing, Medical Coding, Medical Management, and Wound Care.
Shishir Shah, DO, CWS, ABPMSCOTTSDALE, Arizona
Wound Care, Medical Management - bedsores, skin injuries, surgical wounds, burns, pressure ulcers, venous ulcers, hyperbaric oxygen, infections, nursing home, medical devices, telemedicine, scar, qui tam, medical necessity, fraud, patents, medical devices, medical director, decubitus ulcers, diabetic ulcers, regenerative medicine
Award-winning wound care physician in active clinical practice. Wound care clinical, safety ,and leadership experience in acute care, skilled nursing (nursing homes), rehabilitation, and home health settings. Certified Wound Specialist (CWS) with additional Board Certifications in Hyperbaric Medicine and Family Practice. Has served as the medical director of several wound programs. Over twenty years of medical necessity/utilization review and expert witness experience. Midwestern University Medical School faculty. Significant private equity, medical device, startup, and consulting experience. Undergraduate degree in aeronautical engineering, Rensselaer Polytechnic Institute. Deposition and trial experience in multiple states. Over 85,000 wound encounters. Key roles have included medical director oversight of several level 1 hospital trauma wound programs, 5 community hospital wound programs, and over 15 SNF/LTACHs. Co-implemented one of the largest wound care/hyperbaric clinical de...
Frank L Brown, Jr, MD, FACP, FACEP, FRSM, FCP(E)Bluffton, South Carolina
Medical Management, Insurance - Accountable Care Organizations (ACO), Health Insurance, Grievances, Pharmacology, Provider Credentialing, Medical Management, Medical Necessity, Medicare, Medicaid, Healthcare Fraud & Abuse, Medical Billing & Coding, Medical Utilization, Utilization Review, Qui Tam, Clinical Case Theory Development.
Senior physician executive in the health insurance industry, with licensure in Kentucky, North Carolina, Pennsylvania, and Virginia. Certified as Health Insurance Executive. National insurance companies worked for include Oxford Healthplans, Blue Cross & Blue Shield, Wellpoint, Anthem, and Cigna. Responsibilities have included case management, fraud and abuse, physician credentialing, peer review, physician grievances & appeals, patient grievance & appeals, and patient safety. Board-certified in both internal medicine, and emergency medicine. Holder of multiple patents. Experienced public speaker. Chief Medical Correspondent WVGB-FM in Beaufort, South Carolina. Yale-educated, NIH trained. Conducted over 5,000 physician credentialing reviews; over 5,000 medical necessity/utilization management reviews; patient & physician appeals, & hearings; and over 2,000 committee and in-person patient grievance & appeal reviews. Served as an Examiner for the Malcolm Baldrige National Quality...
James E Alexander, Jr., MD Healthcare Compliance Management, LLCFort 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).