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Profile: Lamar Blount, founder Health Law Network

Healthcare Litigation Support & Expert Witness Services
P.O. Box 2166
Atlanta, GA 30077-2166
Phone: (770) 645-5989

Lamar Blount, CPA, FHFMA, founder of Health Law Network, has 30+ years of experience serving the healthcare industry, providing consulting services for more than 500 clients nationwide and internationally. Mr. Blount directs HLN's team of senior consultants with specific expertise, such as coding, clinical and quality issues, and he is typically the testifying expert.

Mr. Blount has provided litigation support in over 100 cases and has been admitted as an expert in multiple US District Courts, State Courts and Administrative Hearings. He has testified for plaintiffs and defendants, as well as for providers, payors and government clients. With HLN, Mr. Blount has served many of the best recognized national healthcare law firms, as well as many of the top healthcare provider organizations and insurors.

Mr. Blount co-authored the American Medical Association's best selling third edition Mastering the Reimbursement Process book, has served as independent arbitrator for the nationally recognized AHLA Alternative Dispute Resolution Service.

U.S. District Court for NJ, Judge Jerome Simandle's opinion stated, "Mr. Blount is qualified to testify as an expert on Medicare reimbursement and billing issues. He possesses specialized knowledge, based on his over thirty years extensive experience as a healthcare auditor addressing Medicare reimbursement concerns and through his published works." (Landau v. Lucasti, Civil No. 06-1229)

Education/Licenses

CPA (1973)
BBA - Georgia Southern University, Accounting (1974)

Experience:

Founder and Chairman
- Healthcare Management Advisors (1990 to 2002)
Provided compliance, reimbursement, coding, managed care, clinical data and financial management expertise to over 1,600 hospitals and hundreds of other healthcare providers nationwide and internationally. Clients included: Hospital Corporation of America, Tenet Physician Specialty Corporation, Veterans Administration, North Broward Hospital District, Memorial Hermann Healthcare System, Emory Healthcare, Baptist Healthcare System.

Co-founder and Audit and Healthcare Consulting Partner - Hyatt, Imler, Ott & Blount (1981 - 1990)
Developed and marketed microcomputer-based software for medical records, budgeting, and rate setting to over 600 hospitals nationwide. Designed the RatePlan procedural rate optimization system, still used by 3M Consulting Services.

Manager - Ernst & Young (1974 - 1981)
Supervised healthcare audits, Medicare & Medicaid cost reports, rate setting and feasibility studies. Assisted national office in several revisions of the KOSTPAK cost report preparation system.
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Area(s) of Expertise

Health Law Network consultants' practice expertise includes:

  • Accounting
  • Antitrust
  • APCs
  • Billing
  • Clinical Documentation
  • Compliance Programs
  • Contractual Disputes
  • Cost Reports
  • Damages Quantification
  • DRGs
  • ERISA
  • False Claims
  • Fraud
  • HIPAA
  • ICD & CPT Coding
  • Insurance
  • IRO Services
  • Managed Care
  • Medical Records
  • Medicare & Medicaid
  • Physician Services
  • Practice Assessments
  • Privacy
  • Professional Standards
  • Rate Setting
  • Quality of Care
  • RAC Audits
  • Self Disclosure
  • UCR Charges
  • Valuations


Representative Engagements:

  • 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.
  • Assisted law firm representing one of the largest hospital chains in rebutting an insurance carrier's allegations of unbundled charges and charges not allowed by Medicare for PPO patients.
  • 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.
  • Assisted law firm representing one of the largest national HMO providers in defending against allegations of improper payments and recovering overpayments.
  • Assisted law firm representing one of the largest US health insurance carriers in pursuing a fraudulent lab services provider.
  • Assisted law firm representing a large hospital chain by providing rebuttal report on the projected financial costs for a life care plan.
  • 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.
  • Assisted law firm representing one of the largest national oxygen provider chains to defend against allegations of Medicare false claims.
  • Assisted attorney defending a physician against allegations of overcoding and false claims, involving 1995 and 1997 E&M documentation standards and certain CPT codes.
  • Assisted law firm representing a national benefits broker against allegations of the insurance brokers negligence regarding standards that are usual and customary in the health benefits industry.
  • Assisted law firm in an appeal to defend a multi-hospital system against allegations by a national hospital chain that the purchase price for a hospital should be revised.
  • Assisted law firm in a medical malpractice cases to evaluate medical records for completeness and identify potential spoliation of evidence for records that should have been included.
  • Assisted law firm representing a national HMO in a dispute over the prompt payment requirements and the completeness of claims involving over $1 million in disputed claims.
  • Assisted a state Attorney General office to evaluate their State Auditor's results for possible use in criminal fraud charges against a home health provider.
  • Assisted law firm in evaluating the results achieved by a medical billing and collections service in comparison to industry averages.
  • Evaluated the reasonableness of potential Medicare and Medicaid reimbursement losses resulting from a fire that destroyed certain medical records.
  • Assisted law firm in quantification of proper payments for inpatient outlier claims, non-ASC procedures and late claims in a dispute between a managed care organization and a hospital.
  • Engaged by a state Medical Board of Examiners to evaluate the reasonableness of charges for a physician's claims.
  • Assisted law firm in reviewing over 50,000 pages of documents to evaluate compliance with Medicare's "incident to" requirements.