Publications
- Could ICD-10 be as big as the mortgage crisis.pdf
- HIPAA Privacy and Security in the Mobile World
- Flaw in the Accountable Care Model Leaves Patients Out
- Esoteric Tests Witness qualifications Michael Arrigo No World Borders.pdf
- Clinical Documentation as Foundation for Risk Adjustment and Value Based Care
- Patent Infringement Cases - Retained as Expert Consultant
- Weslaw - US District Judge Lew Denies Motion to Exclude Arrigo, Affirms Expert Qualifications
- Certification - Ambulance Documentation and Coding
- Certification - HIPAA
- Certification Certified Professional Medical Auditor
Medical billing, fraud, HIPAA privacy, damages
Contact this Expert Witness
- Additional States: Colorado, Florida, Louisiana, Nevada, New Jersey, New York, Texas, and Washington
- Company: No World Borders
- Phone: 949-335-5580 x101
- Cell: 415-933-9714
- Website: noworldborders.com/expert-witness/
Specialties & Experience of this Expert Witness
General Specialties:
Medical Billing and HIPAAKeywords/Search Terms:
Medical billing expert, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act, Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid, insurance, EMTALA, HIPAA, rebut life care, Usual Customary Reasonable (UCR), damagesEducation:
Studies in Bioethics , Harvard Medical School; Bachelor of Science Business Administration, University of Southern California; Statistics and Economics, UC Irvine; Studies in Biomedical Informatics, Stanford Medical SchoolYears in Practice:
22Number of Times Deposed/Testified in Last 4 Yrs:
25Additional Information
Summary of Qualifications National healthcare expert witness with extensive federal and state court experience. Published author, speaker, and peer-reviewed authority featured in Westlaw federal court rulings. Federal Precedent: Expert opinions considered by the U.S. Court of Appeals, resulting in a Vacated and Remanded ruling. DOJ Retentions: Retained twice by the Department of Justice, contributing to a $155 million settlement. Advanced Credentials: Specialized studies in HIPAA Privacy, Security, and Blockchain at MIT. Areas of Expertise Medical Billing, Coding & Reimbursement: Usual, Customary, and Reasonable (UCR) charges in personal injury and medical malpractice; Affordable Care Act (ACA) Life Care Plan rebuttals (future cost of care); trauma, workers' compensation, liens, balance billing, subrogation, and uninsured patient discounts (including California law/Knox-Keene Act). Healthcare IT & Forensics: Technical Expert in healthcare IT patents and intellectual property; Electronic Health Record (EHR/EMR) forensics; practice management software; HL7; Computer-Assisted Coding (CAC). Regulatory Compliance & Fraud: False Claims Act / Qui Tam actions; Stark Law, Anti-Kickback Statute, Sunshine Act, HIPAA, and Insurance Bad Faith. Expert in Medicare Secondary Payor Act, ERISA self-insured plan regulations (cost-sharing, full/fair review), MIPS, MACRA, and Medicare Administrative Contractors (MACs). Clinical & Laboratory Specialties: Medicare Part C/HCC risk adjustment, Accountable Care Organizations (ACOs), PBMs, and pharmaceuticals. High-complexity billing accuracy for genetic sequencing, esoteric laboratory testing (CLIA), pathology, pain management (ketamine, spinal cord stimulators, blocks), anesthesia, nephrology (ESRD), cardiology, and orthopedics. Institutional & Facility Operations: FQHC, ASC, EMTALA compliance, Independent Diagnostic Testing Facility (IDTF) coverage determinations, and payor/physician-hospital contracting.