Contact Information Title Organization Office Phone Cell Phone Links to Social Media reference-id Locations City 1 State 1 :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY City 2 State 2 :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY City 3 State 3 :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Demographic Information Birth Year Race :--Select-- White Black or African-American Asian American Indian or Alaska Native Native Hawaiian or other Pacific Islander Two or More Races Prefer not to answer this question Are You Hispanic? :--Select-- Yes No Prefer not to answer this question Gender :--Select-- Transgender Gender Neutral Male Female Prefer not to answer this question Sexual Orientation :--Select-- Heterosexual Lesbian/Gay/Bisexual Prefer not to answer this question Are You a Veteran? :--Select-- Yes No Prefer not to answer this question Are You Disabled? :--Select-- Yes No Prefer not to answer this question Rosters Arbitrator Mediator Hearing Officer (peer review) Education See Resume Name of School 1 Degree Year Name of School 2 Degree Year Name of School 3 Degree Year Name of School 4 Degree Year Licenses Profession :--Select-- Attorney Physician Registered Nurse Licensed Practical Nurse Nurse Practitioner Licensed Clinical Social Worker Psychologist Certified Public Accountant Master’s in Business Administration Master’s in Public Health Other (please specify) Specialty State :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Since (year) Profession :--Select-- Attorney Physician Registered Nurse Licensed Practical Nurse Nurse Practitioner Licensed Clinical Social Worker Psychologist Certified Public Accountant Master’s in Business Administration Master’s in Public Health Other (please specify) Specialty (if applicable) State :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Since (year) Profession :--Select-- Attorney Physician Registered Nurse Licensed Practical Nurse Nurse Practitioner Licensed Clinical Social Worker Psychologist Certified Public Accountant Master’s in Business Administration Master’s in Public Health Other (please specify) Specialty (if applicable) State :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Since (year) Profession :--Select-- Attorney Physician Registered Nurse Licensed Practical Nurse Nurse Practitioner Licensed Clinical Social Worker Psychologist Certified Public Accountant Master’s in Business Administration Master’s in Public Health Other (please specify) Specialty (if applicable) State :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Since (year) Other (please specify) Specialty (if applicable) State :--Select-- AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UM UT VA VI VT WA WI WV WY Since (year) Fees and Hours My rate is $ per hour per day I charge for travel time as follows: I charge for cancellations as follows: Other information about my fees: I limit meetings and hearings to the following days of the week and/or hours: I am willing to schedule meetings and hearings at night or on weekends. Health Law Expertise Reimbursement Medicare Advantage Medicaid Managed Care Medicaid reimbursement (fee-for-service) Medicare reimbursement (fee-for-service) Other reimbursement (TriCare/ Indian Health/ etc) Private health plan reimbursement Private health plan audits Government payment audits (ZPIC/ MFCU/ etc) Benefits/ERISA issues Direct to employer or patient contracting My expertise is derived from Representing payers-general My expertise is derived from Representing payers-litigation My expertise is derived from Representing providers-general My expertise is derived from Representing providers-litigation My expertise is derived from Government service-general My expertise is derived from Government service-administrative hearings My expertise is derived from Service as a neutral Other Employment Physician compensation and benefits Physician extenders (NP/ PA/ CRNA) Executive and administrative personnel Civil Rights (due process/ wrongful discharge/ discrimination/ retaliation/ harassment/ whistleblowing) My expertise is derived from Representing employees-general My expertise is derived from Representing employee-litigation My expertise is derived from Representing employers-general My expertise is derived from Representing employers-litigation My expertise is derived from Service as a neutral Other Transactions Service agreements Joint ventures Mergers and acquisitions Real Estate/MOBs Ground lease transactions Intellectual property (including hardware and software licenses and SAAS) My expertise is derived from Representing health care providers My expertise is derived from Representing vendors to health care providers My expertise is derived from Service as a neutral Other Organizations Service agreements Joint ventures Mergers and acquisitions Real Estate/MOBs Ground lease transactions Intellectual property (including hardware and software licenses and SAAS) My expertise is derived from Representing health care providers My expertise is derived from Representing vendors to health care providers My expertise is derived from Service as a neutral Other Torts Medical Malpractice Resident/Patient abuse or neglect Business torts My expertise is derived from Representing hospitals My expertise is derived from Representing long-term care facilities My expertise is derived from Representing patients My expertise is derived from Representing residents in long-term care facilities My expertise is derived from Serving as a neutral Other Hospital-Based Health Care Academic medical center Children’s medical center Critical access/rural health General acute care Psychiatric Health Care Outside Hospitals Ambulatory surgical center Behavioral health Dialysis centers Drug addiction Long-term care Post-acute care Subacute care Urgent care My expertise is derived from In-house non-litigation counsel My expertise is derived from In-house litigation counsel My expertise is derived from Outside non-litigation counsel My expertise is derived from Litigating against health care organizations My expertise is derived from Service as a neutral Other Physician Entities Accountable care organization Clinical integrated network Independent practice organization Physician group/practice Patient Information Privacy and security (HIPAA/GDPR) Health information technology/Electronic medical records My expertise is derived from Advising clients on these issues My expertise is derived from Employment with a vendor My expertise is derived from Counsel to health care provider My expertise is derived from Counsel to vendor My expertise is derived from Service as a neutral Other Governance and Finance Governance and business issues Finance (private equity, tax-exempt bond financing, valuation) Taxation of exempt organizations Taxation of non-exempt organizations Bankruptcy/restructuring My expertise is derived from In house counsel My expertise is derived from Outside counsel My expertise is derived from Advising clients on these issues My expertise is derived from Litigating on these issues My expertise is derived from Service as a neutral Other Government Regulation and Oversight Anti-Kickback Law (Federal/State) Stark/Mini-Stark State Laws Antitrust Certificate of Need Corporate Practice of Medicine Government Audits (CMS, RAC, ZPIC, MFCU) My expertise is derived from Advising clients on these issues My expertise is derived from Litigation on these issues My expertise is derived from Administrative proceedings on these issues My expertise is derived from Government service My expertise is derived from Service as a neutral Other Licensing, Credentialing, and Certification Peer review/ NPDB/HIPDB Licensure of health care practitioners Fair Hearings Medical staff My expertise is derived from Representing provider orgs/medical staffs My expertise is derived from Representing health care professionals My expertise is derived from Serving as hearing officer/arbitrator Other Life Sciences and Medical Products 340b drug pricing Devices Durable Medical Equipment Biotech My expertise is derived from Advising clients on these issues My expertise is derived from Litigation/administrative proceedings on these issues My expertise is derived from Service as a neutral Other Training and Experience Basic Training Arbitration - Name of Provider Arbitration - Number of Hours Mediation - Name of Provider Mediation - Number of Hours Hearing Officer - Name of Provider Hearing Officer - Number of Hours I completed the 4 hour hearing officer training course provided by AHLA. Advanced Training See resume Please include provider name, course title, and hours. Experience Arbitrator Single/Lead/Panel Chair Arbitrator Panel Member Arbitrator Advocate Mediator Single/Lead/Panel Chair Mediator Advocate Hearing Officer Single/Lead/Panel Chair Hearing Officer Advocate Litigator Single/Lead/Panel Chair Judge Presentations and Publications My resume lists articles I have written or training I have provided on dispute resolution I have provided training or published articles on the following dispute resolution related topics: References Arb Ref 1 Name Organization Phone Email Arb Ref 2 Name Organization Phone Email Arb Ref 3 Name Organization Phone Email Med Ref 1 Name Organization Phone Email Med Ref 2 Name Organization Phone Email Med Ref 3 Name Organization Phone Email Peer Review Ref 1 Name Organization Phone Email Peer Review Ref 2 Name Organization Phone Email Peer Review Ref 3 Name Organization Phone Email Personal Statement Parties should select me as a neutral because:
