Expert Witnesses & Forensic Consultants Directory

Managed Care (HMO) — Connecticut

Managed care Connecticut expert witnesses provide audits, reviews and written opinions on health insurance and managed care issues, including disputes involving coverage (eg: denial of benefit claims for preexisting conditions, diagnostic admissions, elective procedures), claims under the Employee Retirement Income Security Act of 1974 (ERISA) and non-ERISA plans.
   The managed care experts profiled in this directory may consult on disputes with professional providers over usual, customary and reasonable [UCR rates, alleged overprovisioning of medical services, and allegations of consumer and provider fraud.
   Managed care experts may provide opinions on disputes with institutional providers (eg: hospitals, emergency services, home health providers, nursing homes), including payment practices, appropriate fees, the calculation of payments, unfair competition and antitrust claims.
   These managed care experts may also have specific expertise in matters involving claims against bankrupt care providers and claims by them and consumers against managed care entities.
   These managed care experts may have specific expertise in Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Point of Service Plans (POSs) and/or Exclusive Provider Organizations (EPOs).
   These experts may also testify in matters of alleged HIPAA data breaches and compliance with health care legislation, such as the ACA (Patient Protection and Affordable Care Act, also known as the “Affordable Care Act” and “Obamacare”), coordinated care, care contracting, medical program planning and related matters.

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Chula Vista, CA