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Coding and Billing Litigation in Healthcare: Risk Areas, Disputes, and Expert Insight (VMG Health)

Master litigation strategies for healthcare coding and billing disputes, from contesting extrapolated damages to deploying expert analysis in high-stakes enforcement matters.

2026-04-15 13:00:00

1 hours

Program Details

2026-04-15 13:00:00

2026-04-15 13:00:00

Over 1,000+ webinars

2026-04-15 13:00:00

1 hours

Program Details

2026-04-15 13:00:00

Program Details

2026-04-15 13:00:00

Over 1,000+ webinars

2026-04-15 13:00:00

1 hours

Course Overview

One Billing Code, Millions in Exposure

2026-04-15 13:00:00

Attorneys will gain a litigation-tested framework for evaluating coding claims, contesting financial exposure, and deploying expert analysis across healthcare billing disputes. These skills apply immediately to federal enforcement defense, audit response, and compliance advisory.

Format

CLE Credit

1h CLE Credits

Level

Intermediate

Length

1

Key topics that will be covered

01
Coding Gray Areas
Why most disputes stem from documentation gaps and ambiguity, not intentional fraud.
02
Statistical Extrapolation
How auditors convert small error samples into large damages claims and how to contest them.
03
Expert Strategy
When and how to engage coding, statistical, and damages experts for effective litigation positioning.
04
Audit Response
How to advise clients when government inquiries or audit notices arrive and when disclosure is strategic.
05
Risk Management
Identifying billing compliance vulnerabilities proactively to reduce exposure to future enforcement claims.
06
FCA Enforcement
How whistleblower complaints and government investigations trigger high-stakes billing litigation against providers.

Program schedule

clock 1:00 pm - 1:15 pm EST

How Coding and Billing Disputes Arise: The Legal and Regulatory Landscape

Attorneys will examine the healthcare billing system and where legal disputes originate under the False Claims Act, Anti-Kickback Statute, and Stark Law, including how government audits and whistleblower complaints trigger investigations.

Frank CohenFrank Cohen
Pam D’ApuzzoPam D’Apuzzo
clock 1:15 pm - 1:30 pm EST

Navigating Gray Areas: Why Most Coding Disputes Are Not Black and White

The same clinical encounter can legitimately support more than one code. Speakers will address how documentation gaps create legal vulnerability without fraudulent intent and what a defensible position looks like from both sides.

Frank CohenFrank Cohen
Pam D’ApuzzoPam D’Apuzzo
clock 1:30 pm - 1:45 pm EST

Extrapolation, Statistical Analysis, and Financial Exposure

Statistical sampling can convert a small number of coding errors into multimillion-dollar claims. Attendees will learn the legal and methodological standards for contesting those projections and practical strategies to limit calculated damages.

Frank CohenFrank Cohen
Pam D’ApuzzoPam D’Apuzzo
clock 1:45 pm - 1:55 pm EST

The Strategic Use of Experts in Coding and Billing Litigation

Coding auditors, statisticians, and damages analysts each play distinct roles in billing cases. Speakers will cover how to retain and position these experts effectively and address common vulnerabilities they face on cross-examination.

Frank CohenFrank Cohen
Pam D’ApuzzoPam D’Apuzzo
clock 1:55 pm - 2:00 pm EST

Proactive Risk Management: Advising Clients Before a Dispute Arises

Counsel will gain a framework for identifying billing risk areas, strengthening compliance posture, and advising on audit preparedness and voluntary disclosure before coding issues become enforcement targets.

Frank CohenFrank Cohen
Pam D’ApuzzoPam D’Apuzzo
Pam D’Apuzzo

Pam D’Apuzzo

VMG Health

Frank Cohen

Frank Cohen

VMG Health

Pam D’Apuzzo

Pam D’Apuzzo

VMG Health

Pam D’Apuzzo is a nationally recognized coding and compliance expert with more than 30 years of experience advising some of the country’s leading healthcare institutions. As Managing Director of Revenue Optimization Consulting at VMG Health, she specializes in coding audit and compliance services, corporate compliance program development, and revenue integrity, bringing deep technical knowledge and practical insight to complex billing and documentation challenges. Her clients range from academic medical centers and community hospitals to faculty practice plans and large private practices, and she is widely regarded as a trusted adviser to New York’s premier healthcare organizations.

Education & Credentials

Pam holds multiple nationally recognized credentials, including Certified Professional Coder (CPC) and Certified Professional Medical Auditor (CPMA) through the AAPC, Professional Coding Specialist (PCS) through the ACMCS, and ACS-EM and ACS-MS designations through the Board of Medical Specialty Coding. She is also a certified ICD-10-CM Trainer.

Recognition & Leadership

Pam is recognized as a leading authority in healthcare coding, compliance, and revenue integrity, with more than three decades of advisory work at the highest levels of the industry. She has built a distinguished reputation as a trusted institutional adviser and sought-after educator for major academic medical centers, health systems, and physician organizations nationwide.

Professional Involvement

Pam is a frequent speaker at conferences hosted by the AAPC, HFMA, the New York State Society of Physician Assistants, the Suffolk County Medical Society, and the American Association of Gynecologic Laparoscopists. She is actively engaged in the healthcare compliance and coding community through education, training, and industry leadership.

Experience

Pam's 30-plus years of consulting experience span coding and documentation audits, revenue integrity, billing office assessments, and corporate compliance program development across a wide range of specialties and care settings. She has worked extensively with ambulatory surgery centers, physician practices, hospital-based medicine, oncology, ophthalmology, and behavioral health, and her practice includes operational review, practice start-up assistance, EMR implementation, and compliance advisory.
Frank Cohen

Frank Cohen

VMG Health

Frank Cohen is a nationally recognized healthcare data scientist and computational statistician whose work sits at the intersection of analytics, compliance, and litigation support. As Senior Data Scientist at VMG Health, he brings a rigorous, evidence-based approach to some of the most technically complex challenges in healthcare, from predictive risk modeling and machine learning to statistical sampling and expert analysis in high-stakes legal matters. With decades of experience spanning clinical practice, hospital administration, and consulting, Frank is a trusted resource for healthcare organizations, legal and accounting firms, and government agencies seeking data-driven insight and defensible analytical frameworks.

Education & Credentials

Frank holds a deep foundation in computational statistics and applied healthcare analytics, with expertise in predictive modeling, machine learning, and algorithmic development. He is a published author of Don't Do Something, Just Stand There: A Primer on Evidence-Based Thinking, and has contributed to numerous peer-reviewed articles and industry studies.

Recognition & Leadership

Frank is widely recognized as a leading expert in healthcare statistical analysis, audit methodology, and litigation support. He has trained thousands of healthcare professionals, including physicians, administrators, and CPAs, in the practical application of analytics, and is a sought-after speaker at national conferences and CLE programs.

Professional Involvement

Frank is a frequent speaker at national healthcare conferences and CLE programs, and regularly publishes analysis on compliance, audit risk, and regulatory developments. He has served as a contributing expert for hospitals, law firms, professional associations, and government agencies nationwide.

Experience

Frank's career spans clinical practice, hospital administration, and healthcare consulting, including eight years as a Physician Assistant in the United States Navy and executive roles as clinic administrator and hospital CEO. In consulting, he has worked on more than 300 litigation and compliance matters, specializing in statistical sampling, extrapolation methodology, and coding and billing analysis, and is a valued expert witness in False Claims Act investigations and overpayment proceedings.
Pam D’Apuzzo

Pam D’Apuzzo

VMG Health

Pam D’Apuzzo is a nationally recognized coding and compliance expert with more than 30 years of experience advising some of the country’s leading healthcare institutions. As Managing Director of Revenue Optimization Consulting at VMG Health, she specializes in coding audit and compliance services, corporate compliance program development, and revenue integrity, bringing deep technical knowledge and practical insight to complex billing and documentation challenges. Her clients range from academic medical centers and community hospitals to faculty practice plans and large private practices, and she is widely regarded as a trusted adviser to New York’s premier healthcare organizations.

Education & Credentials

Pam holds multiple nationally recognized credentials, including Certified Professional Coder (CPC) and Certified Professional Medical Auditor (CPMA) through the AAPC, Professional Coding Specialist (PCS) through the ACMCS, and ACS-EM and ACS-MS designations through the Board of Medical Specialty Coding. She is also a certified ICD-10-CM Trainer.

Recognition & Leadership

Pam is recognized as a leading authority in healthcare coding, compliance, and revenue integrity, with more than three decades of advisory work at the highest levels of the industry. She has built a distinguished reputation as a trusted institutional adviser and sought-after educator for major academic medical centers, health systems, and physician organizations nationwide.

Professional Involvement

Pam is a frequent speaker at conferences hosted by the AAPC, HFMA, the New York State Society of Physician Assistants, the Suffolk County Medical Society, and the American Association of Gynecologic Laparoscopists. She is actively engaged in the healthcare compliance and coding community through education, training, and industry leadership.

Experience

Pam's 30-plus years of consulting experience span coding and documentation audits, revenue integrity, billing office assessments, and corporate compliance program development across a wide range of specialties and care settings. She has worked extensively with ambulatory surgery centers, physician practices, hospital-based medicine, oncology, ophthalmology, and behavioral health, and her practice includes operational review, practice start-up assistance, EMR implementation, and compliance advisory.
Frank Cohen

Frank Cohen

VMG Health

Frank Cohen is a nationally recognized healthcare data scientist and computational statistician whose work sits at the intersection of analytics, compliance, and litigation support. As Senior Data Scientist at VMG Health, he brings a rigorous, evidence-based approach to some of the most technically complex challenges in healthcare, from predictive risk modeling and machine learning to statistical sampling and expert analysis in high-stakes legal matters. With decades of experience spanning clinical practice, hospital administration, and consulting, Frank is a trusted resource for healthcare organizations, legal and accounting firms, and government agencies seeking data-driven insight and defensible analytical frameworks.

Education & Credentials

Frank holds a deep foundation in computational statistics and applied healthcare analytics, with expertise in predictive modeling, machine learning, and algorithmic development. He is a published author of Don't Do Something, Just Stand There: A Primer on Evidence-Based Thinking, and has contributed to numerous peer-reviewed articles and industry studies.

Recognition & Leadership

Frank is widely recognized as a leading expert in healthcare statistical analysis, audit methodology, and litigation support. He has trained thousands of healthcare professionals, including physicians, administrators, and CPAs, in the practical application of analytics, and is a sought-after speaker at national conferences and CLE programs.

Professional Involvement

Frank is a frequent speaker at national healthcare conferences and CLE programs, and regularly publishes analysis on compliance, audit risk, and regulatory developments. He has served as a contributing expert for hospitals, law firms, professional associations, and government agencies nationwide.

Experience

Frank's career spans clinical practice, hospital administration, and healthcare consulting, including eight years as a Physician Assistant in the United States Navy and executive roles as clinic administrator and hospital CEO. In consulting, he has worked on more than 300 litigation and compliance matters, specializing in statistical sampling, extrapolation methodology, and coding and billing analysis, and is a valued expert witness in False Claims Act investigations and overpayment proceedings.

Credits by state

AK1.0
AL1.0
AR1.0
AZ1.0
CA1.0
CO1.0
CT1.0
DC1.0
DE1.0
FL1.0
GA1.0
HI1.0
IA1.0
ID1.0
IL1.0
IN1.0
KS1.0
KY1.0
LA1.0
MA1.0
MD1.0
ME1.0
MI1.0
MN1.0
MO1.2
MS1.0
MT1.0
NC1.0
ND1.0
NE1.0
NH60.0
NJ1.2
NM1.0
NV1.0
NY1.0
OH1.0
OK1.0
OR1.0
PA1.0
RI1.0
SC1.0
SD1.0
TN1.0
TX1.0
UT1.0
VA1.0
VT1.0
WA1.0
WI1.0
WV1.2
WY1.0

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70,000+

Trusted by Legal Professionals

MCLE Credits

Alabama
Approved
Alaska
Approved
Arizona
Approved
Arkansas
Approved
California
Approved
Colorado
Pending
Connecticut
Approved
Delaware
Pending
District of Columbia
No Required
Florida
Approved
Georgia
Approved
Hawaii
Approved
Idaho
Pending
Illinois
Pending
Indiana
Pending
Iowa
Pending
Kansas
Pending
Kentucky
Pending
Louisiana
Pending
Maine
Pending
Maryland
No Required
Massachusetts
No Required
Michigan
No Required
Minnesota
Approved
Mississippi
Pending
Missouri
Approved
Montana
Pending
Nebraska
Pending
Nevada
Pending
New Hampshire
Approved
New Jersey
Approved
New Mexico
Approved
New York
Approved
North Carolina
Pending
North Dakota
Approved
Ohio
Approved
Oklahoma
Pending
Oregon
Pending
Pennsylvania
Approved
Rhode Island
Pending
South Carolina
Pending
South Dakota
No Required
Tennessee
Approved
Texas
Approved
Utah
Pending
Vermont
Approved
Virginia
Not Eligible
Washington
Approved
West Virginia
Pending
Wisconsin
Approved
Wyoming
Pending

Alabama

Requirements

The Alabama State Bar MCLE Commission requires attorneys to complete 12 credits, including 1 ethics, by December 31 of each year. All credits must be reported by February 15 of the following year. A maximum of 12 credits, including 1 ethics credit, may be carried over for 1 year only.  

Formats

  • Attorneys can earn unlimited “live” credit through live seminars, live webcasts, and co-sponsored locations with MyLAWCLE-Alabama approved programs
  • Attorneys are limited to 6 credits per compliance period of “online” programs through MyLAwCLE On-Demand programs