Health Law Network

Health Law Network

Lamar Blount

PO Box 2166 Atlanta, GA 30077

About the Expert

HLN consults in civil and criminal cases involving: UCR, reasonable charges & reimbursement; forensic audits; provider & payor disputes; medical record & billing documentation; ICD & CPT coding; compliance programs; business damages; and Medicare, Medicaid and Insurance fraud. MD, RN, RHIA, CPC, CFE, ChFC, MHA and CPA experts available.

Areas of Expertise

  • Healthcare Practices and Records
  • Medical / Medicare / Medicaid Fraud
  • Medical Billing, Coding and Insurance

Expert's Profile

HLN's founder co-authored two editions of the AMA's bestselling "Mastering the Reimbursement Process" book, has served on the Editorial Boards for numerous healthcare industry publications, and as an Arbitrator for the American Health Lawyers Association. Since 1990, HLN and its predecessor firm has provided audits, investigations, training and consulting services to hundreds of hospitals, physicians and other healthcare providers nationwide. HLN's professionals have served as consulting experts in hundreds of cases and have been admitted as testifying experts in multiple US District Courts and State Courts.

HLN's expertise includes: Medical Billing, Medicare & Medicaid compliance, reimbursement disputes, clinical documentation, ICD and CPT coding, hospital and professional fee billing, statistical sampling, medical damages, health and disability insurance, Affordable Care Act, forensic accounting, reasonableness of charges, Business Damages, Contractual Disputes, Cost Reports, DRGs, APCs, ERISA, False Claims, Healthcare and Insurance Fraud, HIPAA, Rate Setting, Self-Disclosure and Valuations.


Representative Engagements

+ Developed self disclosure process for 12-hospital group, audited over 1,000 Medicare claims, and statistically projected the overpayment settlement.

+ Assisted law firm representing one of the largest national home health chains to amend over 200 cost reports and recover over $2 million in additional reimbursement.

+ Provided litigation support to law firm defending physician against Medicare fraud charges, including testimony in US District Court.

+ Calculated economic damages and served as advisor to law firm defending a national hospital chain against allegations of lost profits resulting from a failed sale of multiple hospitals.

+ Developed strategic business recommendations for $30 million specialty MD practice to establish succession plan, implement compensation plan and reduce risks.

+ Engaged by a state Medical Board of Examiners to evaluate the reasonableness of charges for a physician's claims.

+ Developed proforma detailed hospital and physician bill totaling over $1 million for an attorney representing a burn victim treated by a hospital that does not charge for its services.

+ Evaluated potential unbundling of IV charges and proper cost report treatment of Observation Beds by multiple hospitals for an HMO.

+ Forensic audit of labor cost and fringe benefits for a $9 million contracted service dispute between two governmental entities.

+ Evaluation and report on usual, customary and reasonable (UCR) medical and prescription charges over 10 years for 20 personal injury plaintiffs involving over 150,000 pages of billing and medical record documents.

+ Developed statistical sampling plan to evaluate over 60,000 Medicare claims in a False Claims Act case within a tight court deadline.

Legal references are available upon request.

Personal Achievements

Publications

  • Mastering the Reimbursement Process - AMA book

Prior assignments

  • • Developed Medicare OIG self disclosure process for 12-hospital group
  • • Amended over 200 cost reports and recover over $2 million in additional reimbursement for national chain
  • • Expert testimony defending physician against criminal Medicare fraud charges
  • • Litigation support defending a national hospital chain against allegations of lost profits
  • • Served as NHLA Arbitrator in dipute between hospital and HMO
  • • Organized and coordinated multi-hospital group reimbursment appeals
  • • Assisted state Attorney General's office investigation of Home Hrealth fraud

Percentage of time spent as expert

  • 25%

Number of expert assignments / year

  • 12

Attorney Endorsed sm

    Courtroom & Deposition Demeanor (1)

  • Rick Mullins - McAfee Taft

  • Knowledge in Area of Expertise (1)

  • Rick Mullins - McAfee Taft

  • Pleasure to Work With (1)

  • Rick Mullins - McAfee Taft

  • Problem Solving - Anticipates Issues / Suggests Solutions (1)

  • Rick Mullins - McAfee Taft

  • Written Reports (1)

  • Rick Mullins - McAfee Taft

Listed in the Following States

Health Law Network is listed with ExpertPages in the following jurisdictions: All US Regions and States, Canada (all Provinces).