COMPLIANCE - Key Persons
Al Bassett has more than 15 years of experience in assisting numerous health care organizations in the development, implementation and evaluation of compliance programs. His areas of compliance program expertise include, board-level oversight of compliance programs, executive-level management of compliance programs, policy and procedure development, education and training, issue identification and resolution, risk assessment and conducting internal investigations.
Mr. Bassett assists hospital clients in conducting risk assessments and remediation activities regarding physician arrangements and fair market value determinations. These reviews are often conducted under direction of counsel and include reviewing arrangements for compliance with the Anti-Kickback Statute and Stark Laws.
He uses his strong government investigative background to assist clients in conducting a wide variety of corporate internal inquiries and investigations.
Job Titles:
- Senior Compliance Specialist
Brian Kozik is a Certified Healthcare Compliance and Certified Healthcare Privacy professional with over 30 years of experience in compliance, privacy and audit. Mr. Kozik is frequently engaged by Strategic Management clients to serve as an interim Compliance Officer until a permanent candidate is hired. Additionally, Mr. Kozik provides consultancy services to Strategic Management clients in the areas of corporate compliance, ethics, internal audit, HIPAA privacy and internal compliance investigations. When advising clients, Mr. Kozik's work places an emphasis on an employee's/physician's awareness of their role within the Compliance Program and a commitment to communication, collaboration, and credibility. He is a recognized expert on federal and state laws and regulations, including the Anti-Kickback Statute, the Stark Law and the HIPAA Privacy and Security Rules. Mr. Kozik also assists health care organizations in navigating and complying with the terms and requirements of their Corporate Integrity Agreement.
Carrie Kusserow is a Certified Compliance and Ethics Professional (CCEP), and is Certified in Healthcare Compliance (CHC) and Certified in Healthcare Privacy Compliance (CHPC). She has over 15 years of experience in health care compliance, with expertise in False Claims, Anti-Kickback regulations, Stark Laws, HIPAA Privacy and Security Rules and fraud, waste and abuse. Ms. Kusserow specializes in compliance advisory services including corporate compliance program development and implementation, evaluation of compliance program effectiveness, compliance risk assessments, policy and procedure development, investigations, and hotline operations and issue management.
Ms. Kusserow has experience working with a variety of health care organizations, including hospitals, physician practices, long-term care organizations, behavioral health providers, home health providers, and managed care organizations. She assists clients with the development, implementation, management, and maintenance of effective compliance programs, as well as conducting compliance program risk assessments and effectiveness reviews. Ms. Kusserow also assists in the development and implementation of remediation plans to address compliance program deficiencies and promote industry best practices. She works with providers on addressing compliance risks; investigates potential violations of laws, regulations, and Code of Conduct; and develops and assesses compliance-related policies. She is experienced in performing regulatory due diligence in connection with potential physician practice acquisitions. Ms. Kusserow performs risk assessment and management services for clients, both general in scope (e.g., identifying all applicable risks), as well as more tailored towards specific risk areas (e.g., HIPAA, physician contracting). She also provides risk remediation services including policy development, employee and physician training, and implementation of proactive and reactive auditing and monitoring practices. She has provided compliance presentations to various health care organizations, and is an experienced compliance trainer at all levels of an organization, including physician and board training. Her training expertise includes, but is not limited to operational and regulatory compliance, Code of Conduct, fraud, waste and abuse, HIPAA Privacy and Security, physician compliance.
Ms. Kusserow is also responsible for oversight of Strategic Management's Compliance Resource Center, which provides sanction and exclusion screening tools and services, anonymous and confidential hotline and reporting systems and a comprehensive library of policy and compliance-related document templates.
Job Titles:
- Attorney
- Managing Senior Consultant
Catie Heindel is an attorney who is certified in Healthcare Compliance (CHC), Healthcare Privacy Compliance (CHPC) and Healthcare Privacy and Security (CHPS). She has over 11 years of experience in the health care compliance industry, with a specific focus on compliance with Anti-Kickback Statute and Stark Laws, HIPAA Privacy, Security and Breach Notification requirements, Managed Care program requirements, and Clinical Research laws and regulations.
Ms. Heindel provides lead consultant compliance advisory services to a variety of health care organizations throughout the country. She provides clients with expert subject matter consulting services relevant to the needs of their Compliance and HIPAA Program daily operations. This includes program development, implementation and ongoing management, regulatory risk assessment, external government audit/review support and independent review organization (IRO) responsibilities. She also assists clients in developing, assessing and implementing policies, procedures and corrective action/remediation plans to address areas for improvement identified during reviews, evaluations, assessments and audits, including those conducted by external organizations and government enforcement agencies.
Ms. Heindel performs regulatory risk assessment and management services for clients, both general in scope (e.g., identifying all applicable risks), as well as more tailored towards specific risk areas (e.g., HIPAA, Clinical Research, Physician Arrangements). She works with clients to develop and implement risk remediation plans based on assessment findings and recommendations. She also frequently provides risk remediation services including policy development, employee education and training, and the implementation of proactive and reactive auditing and monitoring practices. In addition, Ms. Heindel provides guidance to clients relating to compliance with the Anti-Kickback Statute and Stark Law, particularly with respect to different types of physician and vendor arrangements.
Ms. Heindel provides her health care clients with interpretation and guidance of both federal and state-specific health care laws, as well as industry best practices. She assists clients with the development, implementation and revision of compliance policies and procedures, as well as with the design of organization systems to keep policies up to date. She is experienced in developing and delivering training and education to all levels at a health care organization, including physician and Board training.
Ms. Heindel routinely performs HIPAA Privacy Reviews and, as a Certified Healthcare Privacy Professional, she is qualified in the core areas of the HIPAA Administrative Simplification legislation, Transactions and Code Sets Requirements, and Privacy and Security Requirements. She has also provided expert witness services related to HIPAA.
Ms. Heindel has published numerous articles related to health care compliance in the Journal of Health Care Compliance and Compliance Today, and is a regular speaker at nationally recognized health care conferences, such as the annual Health Care Compliance Association (HCCA) Compliance Institute and the HCCA Managed Care Conference.
Job Titles:
- Senior IT Security Consultant
Darius Hall brings a decade of IT security, IT support and systems administration experience to the organization. Mr. Hall currently holds CISSP and CCNA certifications, as well as held CEH, Security + certifications in the past. Mr. Hall has served varying IT functions in the education and government contracting sectors, both solo and as part of small teams. He has extensive experience in Microsoft Windows networks and has deployed, maintained, and supported a wide range of software and hardware for the Windows platform. He has also provided systems security guidance in accordance with NIST guidelines and information security best practices. Mr. Hall currently handles IT security, senior systems administer duties and IT project management for Strategic Management by supporting the day-to-day operation of our IT infrastructure and local and remote consultants.
Job Titles:
- Senior Compliance Specialist
Faye Griffin is Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC) and is a Registered Health Information Management Administrator (RHIA) with over 25 years of experience in healthcare compliance in a variety of compliance related capacities. For a decade, she served in leadership positions including the Regional Corporate Compliance officer for a large health care system with compliance responsibilities for 18 hospitals across four states that included 4 post-acute care facilities and 1000+ clinic physicians. Range of duties included development and management of the compliance & privacy programs for acute care, clinics, laboratory, home care, hospice, and DME. Ms. Griffin is experienced in performing risk assessments, leading compliance investigations, creating action plans, developing staff education, and providing responses relative to Corporate Integrity Agreements, and settlements with the DOJ. She has also analyzed compliance processes to suggest and facilitate improvements to streamline compliance activities.
As a Compliance Officer, Ms. Griffin had responsibility for HIPAA Privacy that included, developing & approving privacy policies, privacy education, breach investigations, breach reports to the Office of Civil Rights, etc. She developed mitigation plans to lower risk of future privacy breaches. She worked closely with the Information Technology department to assess HIPAA Security compliance.
Ms. Griffin is trained to conduct compliance/privacy program gap and effectiveness evaluations and to serve as an Interim or Designated/Interim Compliance Officer, Privacy Officer, or Health Information Management Director. She also has worked as a consultant leading a HIPAA project involving completing a privacy/security risk assessment and the development of privacy policies and procedures; and created annual privacy education programs. She maintained a successful HIPAA/Privacy release of patient information function with no major breaches, as well as a process for auditing and monitoring of coding to support compliant billing.
Ms. Griffin has also served in the position of Health Information Management (HIM) Department Director, responsible for six managers and 95 co-workers and charged with acquiring, analyzing, and protecting digital, electronic, and traditional medical information vital to providing quality patient care. Duties included implementation of a compliant clinical documentation improvement department/program.
Job Titles:
- Attorney
- Senior Consultant
Jennifer Kirchner is an attorney licensed in Illinois and Wisconsin, certified in Healthcare Compliance and Healthcare Research Compliance. Ms. Kirchner has experience in health care compliance, with specific expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, fraud, waste and abuse, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations. She has assisted organizations including physician practices, nursing facilities, and academic medical centers in the development, implementation, and maintenance of their compliance program. Ms. Kirchner has also conducted compliance program effectiveness reviews and gap analyses for physician practices, hospital systems, long-term care centers, nursing facilities, and managed care organizations.
Ms. Kirchner has assisted organizations under Corporate Integrity Agreements with the OIG with Independent Review Organizations reviews and reports. Specifically, Ms. Kirchner has conducted arrangements reviews for physician practices, independent laboratories, a specialized surgery company and behavioral health management service. Ms. Kirchner has also completed reviews and reports related to marketing CIAs for MCOs and served as a Compliance Expert for an international physician specialty group under a CIA.
Ms. Kirchner's other experience includes: Provided ongoing advisory services and compliance advice to a large academic medical center; Provided ongoing advisory services to a third party billing company related to revenue compliance and revenue integrity; Provided advisory services related to the HIPAA Privacy and Security Rules and conducted a Security Rule Risk Assessment for a large oncology group; Conducted a gap analysis and developed a work plan for implementation of compliance programs.
Job Titles:
- Health Care Compliance and Privacy Consultant
- Specialist
Laurel A. Eakes is a health care compliance and privacy consultant with 25 years of professional experience, with a specific focus in HIPAA privacy and security. Ms. Eakes is Certified in Healthcare Privacy Compliance and Certified in Healthcare Compliance. During her tenure at Strategic Management, Ms. Eakes works with clients to address key elements of their compliance program, including hotline operations, policy development and sanction screening, and evaluates the effectiveness of their compliance and privacy programs. She is frequently engaged by clients to step into the Compliance Officer or Privacy Officer role for an interim period through our interim staffing services. Ms. Eakes is skilled at research and analysis of Federal and state privacy and security laws and regulations.
Lisa Shuman is Certified in Healthcare Compliance (CHC), Certified in Healthcare Privacy Compliance (CHPC) and Certified in Healthcare Research Compliance (CHRC). Ms. Shuman's work has included development, implementation and evaluation of compliance programs and HIPAA privacy programs and compliance and privacy gap analysis and risk assessments. Ms. Shuman also develops policies and procedures, Code of Conducts and training material. Ms. Shuman also advises clients on regulatory issues, including billing and coding regulations.
Ms. Shuman specializes in our firm's HIPAA Privacy services, including leading privacy investigations, breach risk assessments, breach notification letters, breach reporting to the Office for Civil Rights and corrective actions plans. Further, she specializes in serving as Interim Compliance Officer and HIPAA Privacy Officer for large health care systems, managed care organizations, comprehensive cancer center and health care business associate.
Ms. Shuman has assisted health care organizations in meeting obligations under CIAs, including implementation of CIA requirements and IRO reviews of arrangements, claims, marketing practices and billing requirements, and mock IRO reviews to help organizations prepare for a CIA.
Natalie Lesnick is an attorney licensed in Ohio and is Certified in Healthcare Compliance (CHC). She specializes in research and analysis of Medicare and Medicaid program rules and federal health care regulations, including HIPAA and the Affordable Care Act. Skilled in regulatory analysis, Ms. Lesnick frequently partners with senior consultants on engagements to asset clients' understanding of and compliance with federal and state healthcare laws and regulations. Additionally, Ms. Lesnick evaluates clients' adherence to Corporate Integrity Agreement (CIA) requirements and the effectiveness of their compliance program. Other duties of hers include providing advisory services and compliance advice to various clients.
Job Titles:
- Auditor
- Nurse
- Registered Nurse
Rachael Price, Registered Nurse, is a seasoned certified inpatient and outpatient coder and a certified documentation improvement professional with many years of experience in health care. She is a Certified Hospice Coder with the Association of Home Care Coding & Compliance and a Resident Assessment Coordinator - Certified with the American Association of Post-Acute Care Nursing. Ms. Price has experience with CPT/ICD9/ICD10/PCS guidelines, compliance audits and medical documentation risk reviews, focusing on Medicare and Medicaid accurate coding and billing for physician practices, hospitals, and post-acute facilities. She is a skilled coder and auditor with experience doing claims audits for a variety of physician practice specialties. Furthermore, Ms. Price has experience doing in-patient hospital audits and is highly skilled in the areas of short-stay and emergency department E/M claims reviews. Additionally, she is experienced in conducting post-acute claims audits in the areas of home health and hospice. Ms. Price has conducted clinical documentation improvement projects and reviews. She has provided education and training in clinical documentation improvement.
Prior to joining Strategic Management, Ms. Price was an inpatient coder/auditor for military hospital facilities, where she reviewed, coded and audited medical records. In addition, Ms. Price provided training and education on correct coding guidelines, disease management, anatomy and physiology. Ms. Price has experience in clinical research, auditing medical reviews for accurate coding, and due diligence for physician practices, hospitals and post-acute facilities. She has also worked for over 10 years as a nurse in a large physician practice in general medicine and otolaryngic allergy.
Richard P. Kusserow established Strategic Management Services, LLC to assist health care organizations develop, implement and assess compliance programs. Mr. Kusserow has worked with health care organizations to conduct compliance program effectiveness evaluations, deliver advisory services, develop policies and procedures and deliver compliance and internal investigations training.
He provides specialized expertise on fraud and abuse, sanctions, exclusion, and debarment processes, as well as regulatory issues arising from the Centers for Medicare & Medicaid Services (CMS). He possesses special and unique expertise involving fraud and abuse laws and regulations, such as the Anti-Kickback Statute and qui tam actions.
Prior to establishing Strategic Management, Mr. Kusserow served 11 years as the Inspector General of HHS, where he was responsible for oversight of agencies with outlays of over $650 billion per year. He provided management direction and program leadership for budget staff, auditors, program analysts and criminal investigators. Mr. Kusserow established policy and published fraud and abuse regulations, provided policy direction for the conduct of audits, investigations and program inspections and evaluations relating to all programs and operations of the HHS. Mr. Kusserow established HHS policies for all aspects of security administration and guidelines for protection of classified documents and material pursuant to and in accordance with the provisions of Executive Order 12065, National Security Information, and safeguarding of non-classified sensitive information.
Job Titles:
- Senior Compliance Specialist
Job Titles:
- Attorney
- Senior Consultant
Robbi-Lynn Watnik is an attorney, Certified in Healthcare Privacy Compliance (CHPC). She has over 35 years of experience in health care policy, with a special focus on health care compliance and privacy over the last 25 years. Ms. Watnik conducts research and analysis of federal regulations around privacy, security, federal health care programs and other government programs. Her duties include providing compliance advisory services, including conducting effectiveness evaluations of Compliance Programs. She has served as Interim Compliance and HIPAA Privacy Officer for a variety of health care organizations. Her experience includes evaluation of the effectiveness of compliance programs for several healthcare systems.
Prior to joining Strategic Management, Ms. Watnik served as the Compliance Officer for a long-term care enterprise, as well as for a network of specialty physician offices. Additionally, Ms. Watnik has decades of experience serving in a variety of compliance related leadership roles with federal health care agencies. At the Veterans Health Administration, she served as Acting Chief and Deputy Chief Officer for the Office of Compliance and Business Integrity. At the Defense Health Agency, she was the HIPAA Compliance Officer and was a member of the Defense Health Agency Privacy Board. She also was a senior compliance consultant and project leader for TRICARE's (the Department of Defense Managed Care Organization) Uniform Business Office, which oversaw billing and claims operations for the military services. As a Legislative Director for a professional association, Ms. Watnik also worked closely with the HHS Office of Inspector General to provide input into the creation of the first several compliance guidance documents for health care entities ranging from hospitals, to third-party medical billing companies, to Medicare+Choice Organizations.
Sally Enoh, a law school graduate with a master's in Healthcare Regulatory Compliance and Risk Management, is skilled in regulatory research and analysis of federal health care regulations including the False Claims Act, Anti-kickback Statute, and HIPAA Privacy and Security Rules. Ms. Enoh assists senior consultants on engagements, such as program development, implementation, evaluation, and management. Additionally, Ms. Enoh performs reviews of compliance programs, evaluates clients' adherence to Corporate Integrity Agreement requirements, and provides compliance advisory services.
Sharon Blackwood is an experienced health care compliance and privacy professional with over 17 years of experience with a focus on program effectiveness, audit and Corporate Integrity Agreement implementation and management. Ms. Blackwood hold an MBA, Certified in Healthcare Compliance and Certified in Healthcare Privacy Compliance, and is a certified Medical Technologist (MT) by the American Society for Clinical Pathology (ASCP). She has extensive compliance and privacy experience as a Compliance and HIPAA Privacy Officer and compliance consultant. She is certified in corporate and HIPPA compliance. Her work has included working with hospitals, academic medical centers, post-acute care, and in other settings. She has served as a Compliance and Privacy Officer for several healthcare organizations, including being the Chief Compliance Officer at a large SC healthcare with a Corporate Integrity Agreement (CIA); Regional Compliance Director for five states with a national clinical lab company out of NJ; Compliance Officer for a health care system for 58 communities in Alaska; and Clinical Compliance Auditor in Alabama for the nation's largest post-acute care provider.
For the last ten years she has been a healthcare compliance consultant and served on multiple occasion as Interim Compliance Officer, including the following engagements.
Job Titles:
- Health Care Compliance Specialist
- Specialist
Steve Brannan is an experienced health care compliance specialist who is engaged by law firms and health care organizations to provide guidance on compliance and governmental investigations. He is an expert on the False Claims Act cases and has on numerous occasions conducted in-depth document reviews and investigations to assist in learning the facts about: (1) Medicare/Medicaid health care fraud and abuse allegations; (2) white collar crime allegations; and (3) public corruption allegations. Furthermore, Mr. Brannan has been frequently engaged to provide his expertise in medical coding to assist attorneys and accountants in the defense of physicians and hospitals.
Mr. Brannan has served on multiple occasions as a Corporate Compliance Officer for physician practices, including on behalf of the University of Alabama Health Service Foundation in Birmingham, Alabama for eight years where he was responsible for overseeing and monitoring the corporate compliance program in a large physician group practice. As the Corporate Compliance Officer, Mr. Brannan's duties included ensuring compliance with the terms of a Settlement Agreement with the US Government. He was called upon to conduct audits of billing records, investigate patient and employee complaints, conduct conflict resolution, as well as ongoing auditing and monitoring of high risk areas, while creating and maintaining the trust and confidence of physicians.
He also served as the Interim Compliance Officer for the Baylor Health Care System's Health Texas Provider Network ("HTPN") that consisted of more than 500 physician medical group subsidiaries and 3,000 independent physicians affiliates who deliver care at 15 Baylor-owned, leased, or affiliated hospitals and six "short-stay" hospitals.
Mr. Brannan retired as a Special Agent of the FBI with 26 years of service. As an FBI Special Agent, was responsible for investigating violations of federal laws, primarily white-collar crime, including public corruption and allegations of bank fraud and embezzlement. He was a hostage negotiator for 14 years and also worked on numerous cases involving allegations of Medicare fraud. He has testified in Federal and State courts more than 100 times.
Job Titles:
- Certified Public Accountant
- Managing Senior Consultant
- Officer for Hospitals
Steve Forman is a certified public accountant with decades of experience in health care compliance. As an experienced health care consultant, Mr. Forman specializes in developing and implementing compliance programs, assessing an organization's vulnerabilities and risks, operational compliance reviews, implementing effective monitoring systems, testing internal compliance controls, developing and delivering compliance education and training programs, and working with senior management and Boards in developing strategic plans.
Mr. Forman has served as a designated compliance officer for hospitals and a third-party provider. He also serves as compliance expert to the Board for organizations under CIAs and leading IRO engagements.
Suzanne Dallas Castaldo, JD, is a certified Healthcare Compliance Professional (CHC), qualified in the development, implementation, and evaluation of compliance programs for the health care industry. She has ten years combined experience as an attorney and health care compliance consultant. Her duties as a consultant include providing health care compliance advisory and training services, and assisting clients in developing, implementing, evaluating, and evidencing effective compliance programs. She has served as an Interim Compliance Officer and also routinely provides advisory services to Compliance Officers.
Ms. Castaldo has assisted a variety of health care providers including hospitals, physician practice groups, skilled nursing facilities, clinical laboratories, managed care organizations, and pharmacies. Her expertise includes development, implementation, management, and maintenance of effective compliance programs, as well as conducting compliance program risk assessments and effectiveness reviews. She advises providers on addressing compliance risks; investigates potential violations of laws, regulations, and Code of Conduct; and develops and assesses compliance-related policies. She assists in the development and implementation of remediation plans to address compliance program deficiencies and promote industry best practices. She is experienced in performing regulatory due diligence in connection with potential acquisitions; developing and implementing compliance programs; and assisting organizations with interpreting regulatory requirements. She provides compliance presentations to various health care organizations and their personnel at all levels.
In addition, she works in the capacity of an Independent Review Organization (IRO) for a variety of health care providers operating under Corporate Integrity Agreements (CIAs) with the Department of Health and Human Services Office of Inspector General (OIG), including managed care organizations, hospitals, and physician practice groups.
Ms. Castaldo has written and published articles in industry journals and newsletters including the Journal of Health Care Compliance and Compliance Today, and is a contributing editor for the BNA/ACCA Compliance Manual.
Job Titles:
- Senior Compliance Specialist
Thomas Herrmann advises health care clients on compliance and regulatory matters, with a focus on development and management of effective health care compliance programs. Mr. Herrmann works with a variety of health care organizations, including hospital, managed care, physician practice and long-term care. Mr. Herrmann is a recognized expert on issues related to the federal Anti-Kickback Statute, Stark Law and the False Claims Act. Accordingly, he is frequently engaged by clients to evaluate physician arrangements and other arrangements that may have a legal implication, assess high risk areas as it relates to legal and regulatory requirements and conduct due-diligence reviews for mergers or acquisitions. He undertakes independent verification reviews for potential self-disclosure to government agencies and counsels clients on risk assessment and remediation strategies. Mr. Herrmann also works with health care clients who are preparing to or who have already entered into a Corporate Integrity Agreement (CIA), by assisting these organizations with implementing policies and processes to comply with the CIA, engaging as an Independent Review Organization, or advising the Board as a Compliance Expert.
Mr. Herrmann has over 30 years of legal experience with the U.S. Department of Health and Human Services. Prior to joining Strategic Management, Mr. Herrmann served a six-year term as an Administrative Appeals Judge on the HHS Medicare Appeals Council. In that capacity, he adjudicated health care provider, supplier and beneficiary cases involving eligibility, coverage, and payment for health care services furnished to Medicare beneficiaries. Additionally, Mr. Herrmann held various high-level positions in HHS OIG, including Director of the OIG's Office of External Affairs, chaired the Task Force on Managed Care, served on the Federal Interagency Suspension and Debarment Coordinating Committee and served as Chief of the Administrative Litigation Branch in the OIG Counsel's Office.
Ms. Carter is a Human Resources Manager with over a decade of successful experience in hiring and employee management. She leads the firm's hiring initiatives, works closely with management to identify the right talent for our organizational needs and delivers a positive on-boarding experience for new employees.