Facility Accused Of Overcharging Patients For Medical Records


Accounting / Medicare Expert

This case involves the alleged overcharge of patients for copies of their medical records. Under state law, it is unlawful to charge patients, and other qualified persons who request copies of patient medical records, more than the costs incurred to copy such records or $0.50 per page — whichever is less. This case involves multiple patient complaints that a medical facility routinely charges $0.50 per page irrespective of whether the costs incurred are less than that. An expert in accounting with particular experience in Medicare cost accounting was sought to review the facts and opine on the standard of care.

Question(s) For Expert Witness

  • 1. Please describe your background in accounting.
  • 2. Do you have experience with Medicare cost reports and allocation methodologies? Please explain.

Expert Witness Response E-109695

I have researched Medicare cost reports and allocation methodologies throughout my career. My strategy for examining cost reports is to evaluate what companies are attempting to shield and shelter in their reports. I am well-versed in a variety of different cost methods and am currently performing a legal analysis of Medicare and Medicaid cost reports from selected long-term care facilities in multiple states to identify excessive costs, understated revenues, overstated revenue adjustments, understated income, unusual revenue, cost adjustments, and audit adjustments, among other issues.

Expert Witness Response E-106900

I am a chief financial officer and technical monitor for Medicare and Medicaid services. I have extensive experience with cost allocation methods and allowable costs through my 16 years in these positions. I allocated costs to patient medical record requests when I prepared reports 20 years ago and continued to analyze and review patient medical record requests through my 16 years. I am also an administrative law judge for a provider reimbursement review board. As a judge, I examine expert witnesses on Medicare cost report accounting.

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