Expert Witness Medicare Fraud Damages qualifications affirmed by U.S. District Judge Lew Ninth Circuit, Central District of California. Michael Arrigo was affirmed as an expert by U.S. District Judge Ronald Lew, Central District of California. Arrigo is retained by a firm representing a Relator (commonly known as a ‘whistleblower’) who identified alleged illegal practices involving Medicare Fraud, Medicaid Fraud (Medi-Cal Fraud in California) as well as violations of anti-kickback statute.
See below to view the Judge’s Ruling published in Westlaw:
“Accordingly, the Court finds that Mr. Arrigo has sufficient specialized knowledge to provide an opinion on the potential Medicare damages.”
“Mr. Arrigo clearly has the relevant qualifications necessary to provide an opinion regarding the potential damages from submission of allegedly false claims. Mr. Arrigo has experience in both state and federal court providing expert opinions that involved medical billing, coding, Medicare, and Medi–Cal. See Arrigo Report, Ex. F. Mr. Arrigo also has training in medical coding and billing reimbursement, and he has spoken on the topic of electronic health records. See Grover Mot. to Exclude Opp’n Decl., Ex. 2. Accordingly, the Court finds that Mr. Arrigo has sufficient specialized knowledge to provide an opinion on the potential Medicare damages.” Expert Witness Medicare Fraud Damages. Expert Medicare Coverage Determinations.
Mr. Arrigo’s opinions do not boil down to simple math. As Mr. Arrigo notes in his Report, he calculated the potential damages by first reviewing patient medical records and Medicare bills
Relator’s counsel provided and matching patient medical numbers in these records. (Arrigo Report 47–52). Mr. Arrigo needed to have knowledge about Medicare billing practices as well as billing codes and the breakdown of medical billing. Therefore, Mr. Arrigo’s opinion is not so simple. Reviewing thousands of pages of medical records and billing is a complicated and time-intensive endeavor.