Michael F Arrigo is the CEO of No World Borders, a company that provides expertise in healthcare data, regulations, and economics. He serves as an expert regarding HIPAA Privacy and HIPAA Security, HITECH Act Protected Health Information Safeguards, Medical Billing, Medical Coding, Insurance Coverage, Hospital Safety Standards and ethical implications of these Standards on patient autonomy beneficence, and justice.
- Prior to founding No World Borders, He has served as an expert witness in federal and state courts and has been affirmed as an expert by judges and arbitrators. His expert work includes retentions by the U.S. Department of Justice.
- He is familiar with Standards for hospital, ambulatory surgery center (ASC), physician, home health, hospice, risk adjusted coding, billing and reimbursement for Accountable Care, Value Based Care and Medicare Part C (Medicare Advantage) as well as Medicare Part A (inpatient), Medicare Part B (outpatient) and Medicare Part D (drugs / pharmaceuticals) as well as Durable Medical Equipment (DME), laboratory billing including toxicology and genetic testing coding and billing.
- He has worked with clients regarding genetics, opioid prescribing, third-party liability and third-party administration, HIPAA privacy breaches, HITECH Act compliance (electronic medical records ), and EHR forensics and audit logs.
- His company has healthcare data analytics capabilities and provides guidance to law firms and regulatory agencies regarding medical billing fraud including Medicare and Medicaid Fraud. He has provided opinions regarding the Affordable Care Act (ACA), also known as "Obamacare."
- ACA topics: Out of Pocket Maximum (OOPM), Minimum Essential Coverage (MEC), Essential Health Benefits (EHB), health insurance exchanges, 'metal' plans, subsidies, and coverage under Medicaid expansion as well as under the Americans with Disabilities Act (ADA) as well as Emergency Medical Treatment and Labor Act (EMTALA) and out-of-network billing and balance billing.
- He serves as an expert for providers, insurance companies and ERISA self-insured employers regarding electronic billing Standards for health care providers and insurance companies.
Mr. Arrigo was an executive in two publicly traded Fortune 100 companies where he lead eCommerce and electronic banking solution development for the largest residential and commercial lenders in the U.S. He led development of loan securitization 'loan vaults' for financial services, streamlining the merging or pooling various financial assets into one group. While there he led one of the largest most complex Sarbanes Oxley implementations in compliance with Section 404 of the Act. He also was on the national standards committees for electronic banking technology and specialized in Fair Credit Reporting Act (FCRA) data privacy.
Prior to that he was CEO of an electronic billing company, the first in the industry with a cloud-based solution. The company licensed its technology to Citrix Systems. Prior to that he held various positions from product manager to executive in software companies in Silicon Valley.
Prior work includes leadership roles in object-oriented software development tools, data encryption software, database software as the first product manager for the Microsoft SQL Server joint venture, advisor on Oracle's joint venture into news data, and various enterprise, consumer and cloud-based software as a service companies. Prior to that he was a product manager and director of product management for Ashton-Tate / Borland's database software products.
Education: U.C. Irvine (computer science, economics, statistical mathematics), University of Southern California (business administration), Stanford Medical School (bioinformatics), Harvard Medical School (bioethics).
Training and certifications: HIPAA for healthcare workers, HIPAA Business Associates, Medical coding and documentation in several medical specialties including orthopedics, cardiology, oncology, dermatology (integumentary system), physical therapy; Certified Professional Medical Auditor (CPMA) trained.
(2021) – NBC News Affiliate KPRC Houston https://www.click2houston.com – COVID-19 Vaccine eligibility – Non-U.S. Citizens from Mexico, Argentina traveling to the U.S. to gain access to the vaccine. Commentary regarding bioethics decisions, the role of hospital ethics committees, American Medical Association ethical guidelines, Stark, Anti-kickback Statutes and inducements to provide care where Medicaid or Medicare is billed for COVID related care or vaccinations. County, State and Federal CDC guidelines regarding classification of patients (Phase 1A, Phase 1B, etc.), Texas Health and Human Services, Texas Department of State Health Services guidelines and protocols.
(2021) Cape Cod Times https://www.capecodtimes.com – COVID-19 contact tracing proven effective by World Health Organization (WHO), Centers for Disease Prevention and Control (CDC); how does a substance use disorder clinic follow both epidemiological guidelines and HIPAA Privacy rule? Who can be notified (i.e. treating medical staff? non-treating medical staff? county, state health departments? public?) of a patient is known to have COVID?
(2020) – KNX 1070 News Radio – Emergency Medical Treatment and Labor Act (EMTALA)
and California law AB-72 regarding balance billing, out of network care. October 22, 2020.
(2020) – Inside Higher Ed - Gag Order or Privacy Concern? When it comes to their students testing positive for COVID-19, professors say they have a right to know and share the information how they deem appropriate. Colleges want to keep those cases close to the vest. Quoted re: HIPAA, FERPA in higher education and student privacy. https://www.insidehighered.com/news/2020/08/31/colleges-want-professors-stay-mum-student-covid-19-cases
(2020) The Lund Report - Moda Wins Supreme Court Case, insurers can collect the $12 billion spent on so-called “risk corridors.” https://www.thelundreport.org/content/moda-wins-supreme-court-case
(2020) – This is Reno - How Reno is grappling with COVID-19 infectious disease https://thisisreno.com/2020/03/podcast-how-reno-is-grappling-with-covid-19/
Patient privacy and how potential COVID-19 patients may impact first responders.
(2020) Tech News World - Ask Siri if You Have the Coronavirus https://www.technewsworld.com/story/Ask-Siri-if-You-Have-the-Coronavirus-86587.html and New Website Aims to Help People Access COVID-19 Testing https://www.technewsworld.com/story/86573.html Discussion regarding infectious disease diagnostic tools
(2020) The Capitol Forum Vol. 8, No. 76 March 2 - Natera: Company Using Incorrect Billing Codes to Inflate Insurance Cost, According to Billing Experts https://thecapitolforum.com
(2020) New England Psychologist - Feds investigate data breach at Maine’s Sweetser https://www.nepsy.com/articles/feds-investigate-data-breach-at-maines-sweetser/
(2019) Fortune.com - Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say he federal government funneled billions in subsidies to software vendors and some overstated or deceived the government about what their products could do, according to whistleblowers. https://fortune.com/longform/electronic-health-records-fraud/
(2019) Kaiser Health News – Electronic Health Records Creating a ‘New Era’ of Health Care Fraud https://khn.org/news/electronic-health-records-creating-a-new-era-of-health-care-fraud-officials-say/
(2019) The Wall Street Journal: New York City Has Been Releasing Burial Records of Fetal Remains—and Names of Women Linked to Them Medical ethicists say publishing such information on Hart Island cemetery is an invasion of privacy that could cause harm https://www.wsj.com/articles/new-york-city-has-been-releasing-burial-records-of-fetal-remainsand-names-of-women-linked-to-them-11566420004
(2018) Kaiser Health News: That’s A Lot of Scratch: The $48,329 Allergy Test
Usual Customary and Reasonable Charges for medical procedures: https://khn.org/news/thats-a-lot-of-scratch-the-48329-allergy-test/
(2018) National Public Radio: Bill Of The Month: A $48,329 Allergy Test Is A Lot Of Scratch https://www.npr.org/sections/health-shots/2018//29/660330047/bill-of-the-month-a-48-329-allergy-test-is-a-lot-of-scratch
(2016) Association of Healthcare Journalists: HIPAA experts: No need to request a waiver after Orlando shootinghttps://healthjournalism.org/blog/2016/06/hipaa-experts-no-need-to-request-a-waiver-after-orlando-shooting/
(2015) Medical Economics: The ICD-10 transition: Avoiding revenue disruptions
(2014) eCommerce Times: Accenture Tapped to Doctor Healthcare.gov https://www.ecommercetimes.com/story/79783.html
(2011) Healthcare IT News - ICD10Watch: 3 lessons Canadian healthcare can teach us about ICD-10 implementation https://www.icd10watch.com/blog/3-lessons-canadian-healthcare-can-teach-us-about-icd-10-implementation
(2011) - Wall Street Journal: Is Switch to New Medical Coding System Health Care’s Y2K Problem? https://blogs.wsj.com/venturecapital/2011/02/22/it-companies-stand-to-gain-from-health-cares-y2k-problem/
(2011) Wall Street Journal: IT Companies Stand To Gain From Health Care’s ‘Y2K’ Problem https://blogs.wsj.com/health/2011/02/23/is-switch-to-new-medical-coding-system-health-cares-y2k-problem/
Arrigo, M. F. (2021) California Knox-Keene Act HMO Regulations re: Out-of-Network Under EMTALA and ERISA. Published February 28, 2021
Arrigo, M. F. (2021) Genetic Testing Ethics Privacy Anti-Discrimination: Rapidly Developing Regulatory Landscape. Published February 5, 2021 https://noworldborders.com/expert-witness/hospital-safety-expert/genetic-testing-ethics-privacy-anti-discrimination/
Arrigo, M. F. (2021) Use of Telemedicine During a Public Health Emergency. Published January 14, 2021 https://noworldborders.com/2021/01/14/use-of-telemedicine-during-a-public-health-emergency/
Arrigo, M. F. (2021) Hospice Care for Medicare Medicaid Tricare Beneficiaries. Published January 10, 2021 https://noworldborders.com/2021/01/10/hospice-care/
Arrigo, M. F. (2020) HIPAA and HITECH Act Serve as Cybersecurity Recognized Security Practices. Published December 26, 2020. https://noworldborders.com/2020/12/26/hipaa-and-hitech-act-serve-as-cybersecurity-standards-for-healthcare/
Arrigo, M. F. (2019) OIG Industry Guidance Sets Standards for Governance by Healthcare Industry Sector. Published November 12, 2019 https://noworldborders.com/2019/11/12/oig-regulatory-guidance-standards/
Arrigo, M. F. (2019) Pharmacy Benefit Managers - U.S. Pharmacy Distribution and Reimbursement System. Published February 4, 2019 https://noworldborders.com/2019/02/04/pharmacybenefitmanagerdrugprices/
Arrigo, M.F. (2019) Pain Management, Addiction Medicine Coding, Billing Expert Provides Guidance to Comply with Medical Necessity, Medical Coding, Medical Billing and Controlled Substances Act Requirements - https://noworldborders.com/expert-witness/pain-management-and-addiction-medicine-coding-and-billing-expert/
Arrigo, M.F. (2019) Medicare 2020 Skilled Nursing Facility PPS Final Rule - The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2020 final rule for the skilled nursing facility prospective payment system (SNFPPS). CMS’ Patient Driven Payment Model (PDPM) will be effective October 1, 2019 https://noworldborders.com/2019/10/02/medicare-2020-skilled-nursing-facility-pps-final-rule/
Arrigo, M. F. (2018) Drug Pricing Expert and Classification Systems: drug classification systems and their impact the overall cost of health care. Published March 1, 2019 https://noworldborders.com/2018/03/01/drug-pricing-classification-systems/
Arrigo, M. F. (2017) American Health Care Act DOA. What Does it Mean for Medical Cost Litigation? Published March 24, 2017 https://noworldborders.com/2017/03/24/american-health-care-act-doa-medical-cost-litigation/
Arrigo, M.F. (2017) Telehealth Visits Show Growth in Benefits for Insureds. Telehealth means and methods as well as coding for enhancing healthcare, public health and health education.
Arrigo, M. F. (2016) Strategic Financial Management for Healthcare Providers: Clinical Documentation Improvement and Accuracy as a Foundation Value Based Care. Peer review, review by clinical and business executives at Baptist Health (a large academic medical center). Healthcare Financial Management (HFMA). Published August 17, 2016. https://www.hfma.org/sfp/
Arrigo, M. F. (2015) Mobile Health, HIPAA Privacy and Security
Blackberry Sharpens Security with Good Technology Acquisition. Gov. Health IT.
Arrigo, M. F. (2015) Five Interest-Piquing Trends at HIMSS15. Gov. Health IT.
Arrigo, M. F. (2014) Cloud and Mobile Convergence: The Regulatory View. Gov. Health IT.
Arrigo, M. F. (2014) Increased Spending - Big Data, Cloud, mHealth Social. Gov. Health IT. http://www.govhealthit.com/blog/increased-spending-and-savings-tap-big-data-cloud-mhealth-and-social
Arrigo, M. F. (2014) Ebola: How cloud, mHealth, and ICD-10 could help. mHealth News. http://www.mhealthnews.com/blog/ebola-how-cloud-mhealth-and-icd-10-could-help
Arrigo, M. F. (2014) How Cloud and mHealth Ease Claims Processing (also coverage of Prior Authorization/Eligibility HIPAA EDI 270/271, referral EDI 278 transaction). Gov. Health IT.
Arrigo, M. F. (2014) How to Get Behavioral Health Codes Right. Gov. Health IT.
Arrigo, M. F. (2013) 3 Top Priorities for CommonWell. Gov. Health IT.
Arrigo, M. F. (2013) Commentary: ICD-10 Arrives Early, New Claims Form. Gov. Health IT. http://www.govhealthit.com/news/commentary-icd-10-arrives-early-claims-CMS-coding-HIPAA-icd-9
Arrigo, M. F. (2012) How a Flaw in the ACO Model Leaves Patients Out. Gov. Health IT. http://www.govhealthit.com/news/how-flaw-aco-model-leaves-patients-out
Arrigo, M. F. (2012) 10 ICD-10 Regulation Myths Demystified. Gov. Health IT.
Arrigo, M. F. (2012) Real-time location, mobile health gain traction. Gov. Health IT.
Arrigo, M. F. (2011) ICD-10 financial impact vs. mortgage crisis? Gov. Health IT.
Arrigo, M.F. (2011) Skilled Nursing Resource Utilization Group (RUG) Classifications.