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JD, University of Texas School of Law
BA, Smith College, cum laude
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Medicare Advantage RADV Audits: Final Retroactive Rulemaking, Business Law Today (ABA) (January 2023).
A Review of the Impact of the 2021 E/M Coding Changes in the Office and Outpatient Setting, Compliance Today, HCCA · Aug 26, 2021
Getting Paid: Why You May Have Not Seen a Pay Increase from the 2021 E/M Code Revaluation, FPM, American Academy of Family Physicians · Jul 16, 2021
“Who’s Overseeing TPE Audits, a Broad Defense to Targeted Probe Educate Reviews”, Health Business Monthly, November 2022.
“Understanding and Challenging Targeted Probe and Educate Reviews,” Business Law Today, (ABA), November 2022.
“A Roadmap to Medical Billing and Coding for Wound Care Providers”, Advances in Skin and Wound Care, December 2022.
“When the Government Comes Knocking at your Door, Trends in Recent SEC and DOJ Enforcement Actions”, Compliance and Ethics Professional Magazine (CEP), June 2020.
“A Review of Trends in Recent FCPA Enforcement Actions: An Audit Perspective,” Compliance Today 2019.
“Medicare Advantage RADV Audits: Final Rule to Invoke Retroactive Rulemaking,” Business Law Today (ABA) January 2023.”
“The Impact of the 2023 CMS RADV Final Rule,” to be published by the TMA in the Fall 2023.”
“How the New RADV Rule Will Affect Physicians” published by the AAFP July 2023, in its FPM journal, Getting Paid, and its newsletter.
“Humana Challenge to 2023 CMS Final RADV Rule: An Attack on Retroactive Rulemaking”, Business Law Today (ABA), January 2024.
“A Discussion of Risks Posed by CMS’s RADV Audit Final Rule,” Business Law Today, (ABA), January 2024.
When the Government Comes Knocking: Trends in FCPA enforcement actions, Compliance and Ethics Professionals Magazine, October 2020. The article discusses the increase in SEC civil enforcement investigations based on violations of the FCPA internal accounting provisions. When the government comes knocking: Trends in FCPA enforcement actions | COSMOS Compliance Universe (compliancecosmos.org)
A Review of the Impact of the 2021 E/M Coding Changes in the Office and Outpatient Setting,
Compliance Today Journal, HCCA · Aug 26, 2021, View PDF (compliancecosmos.org)
Getting Paid: Why You May Have Not Seen a Pay Increase from the 2021 E/M Code Reevaluation, Family Physician Magazine (FPM), American Academy of Family Physicians · Jul 16, 2021. Why you may not have seen a pay increase from the 2021 E/M code revaluation | AAFP
Both the Compliance Today and the FPM articles on the 2021 changes to E/M coding, address the positive impact of the change on physician compensation, resulting from the increase in the conversion factor as part of RVU calculations, the reduction of documentation required. It also provides guidance as to adequate documentation of medical decision making.
“Who’s Overseeing TPE Audits, a Broad Defense to Target Probe Educate Reviews”, American Academy of Professional Coders, November 2022. The article outlines a defense to challenge MAC Target Probe and Educate decisions, based on the lack of CMS oversight of the standards applied in the reviews. Who’s Overseeing TPE Audits? – AAPC Knowledge Center
A Roadmap to Medical Billing and Coding Audits for Wound Care Providers, Advances in Skin and Wound Care Journal, December 2022. The article provides guidance to wound care providers to improve the accuracy and completeness of their clinical documentation to establish compliance with medical necessity requirements. A Roadmap to Medical Billing and Coding Audits for Wound Care Providers – PubMed (nih.gov)
“Understanding and Challenging Targeted Probe and Educate Reviews,” Business Law Today, (ABA), November 2022. The article outlines the risks posed to physicians by Target Probe and Educate reviews and outlines a strategy for challenging adverse decisions. Understanding and Challenging Targeted Probe and Educate Reviews – Business Law Today from ABA
Getting Paid: How the New RADV Rule will Affect Physicians, Family Physician Journal (FPM), American Academy of Family Physicians (2023), How the new “RADV” rule will affect physicians | AAFP
A Discussion of Risks Posed by the 2023 CMS Final RADV Audit Rule, Business Law Today, (ABA), February 15, 2024, “A Discussion of Risks Posed by the 2023 CMS Final RADV Audit Rule
“Medicare Advantage RADV Audits: Final Rule to Invoke Retroactive Rulemaking,” Business Law Today (ABA) January 31, 2023. Medicare Advantage RADV Audits: Final Rule to Invoke Retroactive Rulemaking – Business Law Today from ABA
Humana Challenge to the 2023 CMS Final Rule: An Attack on Retroactive Rulemaking, Business Law Today (ABA), February 16, 2024. Humana Challenge to 2023 CMS Final RADV Rule: An Attack on Retroactive Rulemaking – Business Law Today from ABA
The three articles published in the ABA journal, Business Law Today, question the validity of the retroactive method of determining extrapolated overpayments, and address the unexpected financial obligations the new Final Rule will create.
“Financial Literacy of Physicians,” Dallas County Medical Society newsletter, June 2024. The article provides practical guidance to physicians as to how to build an effective denial management program and monitor their practice’s financial performance. Dallas_Medical_Journal_May_2024 by BMP – Flipsnack