Resume

Sign in

Compliance Officer

Location:
Nashville, Tennessee, United States
Salary:
$150,000 plus commensurate benefits
Posted:
May 23, 2011

Contact this candidate

Resume:

ALLISON K. LUKE, JD, CHC *** *th Avenue N. #***

Nashville, TN 37203

404-***-**** (mobile)

wzetss@r.postjobfree.com

Primary Areas of Expertise

All aspects of healthcare compliance, generally, and strong knowledge of federal and state laws and regulations affecting healthcare providers, facilities and systems, including Federal and State False Claims Acts, Federal Anti-kickback and Stark laws, Medicare and Medicaid Regulations, HIPAA, and others;

Corporate compliance program development and implementation, including Corporate Integrity Agreement implementation; compliance investigations, resolutions, and development/implementation of corrective action plans; development of compliance audit programs, including creation of audit tools, and determination of audit criteria and implementation of compliance audits; policy development and training for healthcare providers; and

Representation of hospitals, healthcare systems, home health agencies, dental practices, and other healthcare providers in compliance investigations before federal and state authorities.

Employment Experience

Church Street Health Management (formerly FORBA Holdings, LLC), Nashville, TN (November 2008 – April 2011)

SVP, Chief Compliance Officer

• Chief Compliance Officer for Church Street Health Management (CSHM) and Associated Dental Centers.

• Leads Compliance Department of 7 people, including, but not limited to, the Compliance Investigations, Compliance Training, Clinical Auditing and the Patient Advocacy functions of the company.

• Oversees all compliance functions of the company, including, but not limited to, enforcement and maintenance of the compliance program for CSHM and Associated Dental Centers; provision of training for all CSHM and Dental Center employees and the CSHM Board; oversight of audit functions; investigation of and response to all compliance-related complaints; chairmanship of Compliance Committee; regular provision of reports to CEO and CSHM Board, including the Compliance Committee of CSHM Board, on compliance activities and investigations, and development of policies and procedures as needed.

• Implemented and enforced compliance with comprehensive Quality of Care Corporate Integrity Agreements (CIAs) with both the US DHHS OIG and the New York State OMIG, which CIA encompasses 71 dental centers in 22 states.

Healthcare Integrity Services, LLC, Atlanta, Georgia (January 2006 – November 2008)

President

• President of a healthcare compliance consulting company which provided compliance services and focused assistance to a variety of healthcare providers, including, but not limited to, hospitals, home health agencies, and physician groups, which were predominantly located in the Southeastern United States.

• Represented clients in successful resolutions of government investigations involving compliance matters

o Completed successful Voluntary Disclosures to and Settlements with the DoJ and OIG

o Represented Clients upon notice of ongoing government investigations and assisted in the successful settlement of investigations.

• Served as an expert witness in the healthcare compliance field in a federal False Claims Act trial.

CareSouth Health System, Augusta, Georgia (March 2000 – December 2005)

Vice President and Chief Compliance Officer

• Chief Compliance Officer for a large national homecare system encompassing home health services and third party billing and management services.

• Revised & adapted existing "on the shelf" compliance program to working effective program;

o Tailored the compliance program functions to fit each of CareSouth’s individual facilities and agencies’ unique compliance issues.

o Instituted successful implementation of compliance audit & review system.

o Successfully addressed numerous and varied compliance problems with appropriate corrective action plans.

o Completed successful Voluntary Disclosures to and Settlements with the DoJ and OIG

Georgia Hospital Association, Marietta, Georgia (February 1993- March 2000)

Regulatory/Legislative Counsel

• Legal Counsel for state hospital association (approximately 170 member hospitals).

o Daily contact with Georgia hospitals and their legal and compliance-related issues for more than 7 years;

o Working knowledge of all aspects of hospital and healthcare laws and regulations in Georgia, including detailed knowledge of federal and state laws and regulations specifically affecting hospitals;

o Routine review and analysis of detailed issues including, but not limited to, Medicaid and Medicare payment rules, corporate compliance, Stark self-referral law & rules, Anti-Kickback Statute, False Claims Act, Antitrust laws, JCAHO, advance directives, EMTALA, CON regulations, hospital authorities, medical staff credentialing & privileges, ADA, OSHA, managed care, professional licensure laws, silent PPOs, and others;

o Contract review

• Preparation of legislation and testimony at both the state and federal levels on a variety of healthcare issues;

o Testified on several occasions before various Georgia State Legislative Committees and Georgia State Regulatory Agencies.

• Testified in many significant hearings on behalf of the hospital and healthcare industry;

o In 1998, testified at the request of the American Hospital Association before a special committee of Department of Justice attorneys and HHS Office of Inspector General attorneys regarding the federal False Claims Act and the need for legislation to amend it relating to health care providers.

• Became expert in healthcare law & earned respect of colleagues both locally and nationally

o Represented the hospital community on the JCAHO Subcommittee for Sentinel Events.

• Became early compliance expert, particularly in the area of the Federal False Claims Act :

o Represented Georgia Hospitals before the DoJ in negotiating the scope of DoJ investigations into the “3 Day Window” rule,

o Represented Georgia Hospitals before the DoJ in negotiating the scope of DoJ investigations into Clinical Laboratory Unbundling, and

o Represented Georgia Hospitals before the DoJ in negotiating the scope of DoJ investigations into Pneumonia Upcoding.

Law Office of Don Smart, Savannah, Georgia (1991-1993)

Associate Attorney

• Insurance Defense Litigation (federal and state trials), including depositions and trial preparation.

o Successfully argued case in federal district court as lead defense attorney;

o Successfully argued two cases before Georgia Court of Appeals;

• Workers’ compensation hearings and Georgia State Board of Workers’ Compensation appeals

Woodall and McGahee, Savannah, Georgia (1990-1991)

Associate Attorney

• Insurance Defense Litigation (federal and state trials), including depositions and trial preparation.

• State Appellate Court appearances;

• Workers’ compensation hearings and Georgia State Board of Workers’ Compensation appeals

Education

Juris Doctor, 1990, The University of Georgia School of Law, Athens, Georgia

B.A., Political Science, 1987, The College of Charleston, Charleston, South Carolina

Certificate of International Studies, 1986, L’Universite d’Aix-Marseille III, Institut de Science Politiques, Aix-en Provence, France

Professional Activities

Certified in Healthcare Compliance (CHC)

Co-Author, Chapter on Home Health Compliance Law, 2006 Health Law and Compliance Update, Aspen Publishers

Current Member, the American Health Lawyers Association, the Health Care Compliance Association, State Bar of Georgia, and the Health Law Section of the State Bar of Georgia

Co-chair, 4th Annual Southeastern Health Fraud Institute, March, 2001 and 5th Annual Southeastern Health Fraud Institute, March 2002; JCAHO Sentinel Events Policy Subcommittee (1999-2000); Hospital representative to the Georgia Task Force on AIDS (1995-2000); Board of Directors, National Mental Health Association of Georgia (1996); and Younger Lawyer Alumni Committee of the University of Georgia School of Law (1994-96)

Frequent national, state and regional speaker on healthcare law and compliance issues generally, including fraud and abuse, the False Claims Act, EMTALA, advance directives, and others

Special Skills

• Fluent in French



Contact this candidate