Charles Overstreet is a senior managing director in FTI’s Forensic and Litigation Consulting practice and is based in Brentwood, Tennessee. Mr. Overstreet has assisted numerous healthcare clients in their development and implementation of strategies for improving operations and regulatory compliance, and brings a strong background in managing organizational transition. His work focuses on assisting clients with creating innovative solutions to delivering and funding patient care that capitalizes on their strengths, responds to the future healthcare needs of their communities, and enhances their compliance with all applicable guidelines. Prior to his years in advisory services, he worked at a large academic and an urban community hospital; he also spent several years as an officer in the U.S. Air Force.
Experience
Forensic & Litigation Experience
Currently leads FTI’s Forensics & Litigation Consulting Healthcare Industry Team:
- Development of corporate compliance programs
- Compliance with Federal and State payment guidelines (documentation, coding, billing, and payment) for healthcare services and Medicare Advantage health plans
- Responses to investigations by the HHS Office of Inspector General, Department of Justice, and other regulatory agencies
- Analysis and testing of current documentation, coding and reimbursement processes to detect inefficiencies and areas of non-compliance
- Assistance with “Self Disclosure” to governmental regulatory agencies
- Implementation and monitoring of corporate integrity agreements
Supported numerous clients in litigation and arbitration related to disputes over payment processes and charging methodologies for healthcare services:
- Provided assistance to a major payor in analyzing claims for payment and hospital charges in their dispute with a multi-hospital regional health system
- Assisted large healthcare companies and healthcare systems in their mediation/arbitration with managed care entities in disputes over payment of charges
Assisted internal audit departments at large health systems and academic medical centers in their review and testing of:
- Revenue integrity processes
- Clinical trials processes
- Fiscal reporting and effort reporting
- Budgetary management and cost allocation
- Billing for clinical services
Healthcare Operations Experience
- Led performance improvement and operations restructuring engagements for numerous healthcare organizations throughout the United States and Southern Canada.
- Provided leadership to clients in developing strategic options in regard to possible mergers, development of integrated systems, development of physician networks, negotiations with managed care companies, and establishment of other alliances.
- Assisted a number of clients in the exploration of strategic business options, including service expansion, consolidation, and divestiture of non-performing assets. All engagements have focused on balancing market demands and operating strategies with prudent economics.
- Led an engagement to assist the board of regents of a state university system with the development of a strategic plan and new governance structure for the system's medical college related hospitals and clinics. The engagement also included a comparative review of governance options from other public sponsored academic medical centers, as well as the potential opportunities that each offered in the achievement of the strategic objectives related to the tripartite academic missions of education, research, and community service.
Selected Experiences
- Led the implementation of the largest Corporate Integrity Agreement signed by the Department of Health and Human Services Office of Inspector General and a healthcare services provider. Served as the Independent Review Organization for that Agreement for eight years.
- Continues to serve as the Independent Review Organization for numerous entities under Corporate Integrity Agreements.
- Assisted a number of institutions in the evaluation of their documentation, accumulation of charges for services provided, coding and reimbursement processes related to all payors, private and governmental. Engagements led to the resolution of disputes between payor and provider, and/or improved compliance documentation accuracy.
- Worked with clients’ external counsel to analyze, test and quantify incidences of non-compliant behavior and subsequent disclosure to the appropriate governmental regulator(s).
- Assisted a private, not-for-profit healthcare management group in their efforts to purchase a health system from a county hospital authority. The engagement involved determining the sale's impact to the community and planning for the future healthcare needs of the community, including indigent care subsidies.
- Led a financial improvement project for a large multi-specialty group practice under the aegis of an academic medical center and medical school. The group was organized into four distinct geographic divisions, with 208 physicians in a myriad of specialties, and penetration of capitated managed care in the four divisions ranging from 56% to 26%. The key deliverables of the project were the individual implementation (action) plans for improvement at regional and divisional levels, and a mechanism to track the on-going success and financial impact of plan implementation
- Assisted a mid-sized health system in their strategic planning for ambulatory services - work involved building a financial model to account for market trends, as well as potential equity-sharing scenarios with community physicians.
- Assisted two hospitals in the detailed assessment of benefits derived from full collaboration and the development of potential consolidation scenarios. The focus of this engagement was the identification of economic benefits (capital costs and operational savings) from consolidating administrative, clinical, ancillary, and support services.
- Assisted a health system in deriving post merger strategies for optimizing clinical services at each campus within the system. The engagement involved leading a representative group of physicians in the analysis of current clinical services offerings with respect to future community healthcare needs, individual campus capabilities, ambulatory alternatives, and facility constraints. The outcome of this work was a physician sponsored plan to migrate clinical services to defined "centers of excellence" within acute and non acute parameters.
- Led a performance improvement efforts and comprehensive reengineering initiatives at numerous healthcare systems and physician clinics. The objectives of these engagements were to improve the cost position through changes in clinical practice, service offerings, as well as process improvement. The resulting reductions in annual recurring costs were in the tens of millions of dollars.
Litigation Experience
Reports
- Greater El Monte Hospital, et al v. Molina Medical Centers, American Arbitration Association Case No. 73193 Y 00372 04 CALC
- Doctors Medical Center of Modesto, et al. v. Health Net, Inc. American Arbitration Association Case No. 72 Y 193 00925 03 ARC
- Civil Action No. C-03-124, Michelle Wedgeworth, Relator Bringing This Action on Behalf of the United States vs. Christus Health System Corp. and Christus Spohn Health System Corp.
- Civil Action 1:03CV777-MHT, United States of America, ex rel. Deana Yeager, Relator, vs. MedQuest Associates, Inc., and Dothan Diagnostic Imaging, Inc.
- Civil Action No. 2:02-cv-189, United States of America, ex rel., Ted Whitten, (Relator) vs. Community Health Systems, Inc., as successor to Triad Hospitals, Inc., as successor to Quorum Health Group, Inc., Quorum Health Resources, Inc., and Quorum Health Resources, LLC.
- Civil Action No. 3:06-1169, United States of America, ex rel., Karen J. Hobbs, (Relator) vs. MedQuest Associates, Inc., BioImaging at Charlotte, Inc., BioImaging of Cool Springs, Inc., and BioImaging at Harding, Inc. (now known as BioImaging at Edmondson).
Deposition and Testimony
- John Muir/Mt. Diablo vs. Health Net, Inc., JAMS Arbitration No. 1210025938.
- Mississippi CON Review #HG-C 1205-049,Forrest General Hospital, Construction/Relocation/Transfer of 30 Orthopedic Beds.
- Civil Action No. 2:02-cv-189, United States of America, ex rel., Ted Whitten, (Relator) vs. Community Health Systems, Inc., as successor to Triad Hospitals, Inc., as successor to Quorum Health Group, Inc., Quorum Health Resources, Inc., and Quorum Health Resources, LLC.
Community Involvement
- Trustee and Recent Past Disbursements Committee Chairman, Beta Psi Foundation (Sigma Chi), Georgia Institute of Technology.
- Board Member, Court Appointed Special Advocate for Children (CASA), Nashville, Tennessee.