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Kenneth
Blickenstaff
Ken L. Blickenstaff has managed and conducted a broad range of healthcare investigations as well as providing fraud awareness and prevention methods to clients. Ken specializes in assisting providers with risk assessments as part of the overall development and implementation of corporate compliance programs. He has also done extensive work related to Corporate Integrity Agreements including annual compliance audits and mandatory training. He also assists payers and government program administrators develop fraud detection techniques as part of claims processing functions.
Ken jointly formed BlickenWolf LLC in 2003 after spending over five years at Deloitte & Touche and nearly two years at KPMG. Prior to that, he served nearly four years as the Director of a Medicaid Fraud Control Unit and former law enforcement officer assigned exclusively to healthcare fraud prosecution. In 1995 and 1996, he was the President of the National Association of Medicaid Fraud Control Units, a group of State based investigators and auditors whose mission is to combat, police, and prevent healthcare fraud and abuse. His anti-fraud efforts involved federal task force investigations in conjunction with the Federal Bureau of Investigation, the Office of Inspector General, Postal Inspectors, and various other federal, State, and local law enforcement agencies.
Before his extensive involvement in the healthcare arena, Ken dealt with the investigation of all types of felony white-collar crime. His work involved a large number of grand jury investigations performed in conjunction with the FBI, the Indiana State Police, and the Indiana State Board of Accounts.
Ken’s Enforcement Experience
- As the Indiana Medicaid Fraud Control Unit Director,
Ken was responsible for the coordination and oversight of statewide
investigations
involving Medicaid and other healthcare program fraud. This
activity involved the investigation of over 500 cases in a representative
two-year period and involved every conceivable category of
providers.
- In the 1995 and 1996 reporting periods for the Medicaid
Fraud Control Unit, Ken was responsible for the recovery of program
and investigative costs totaling over $6,000,000. Both were record
setting years in this category.
- While president of the National Association of Medicaid Fraud Control Units (NAMFCU), Ken was involved in many nationwide healthcare initiatives. He played an integral role in numerous global settlements, coordinating both federal and State interests. He is familiar with high-ranking officials and operations at the Department of Justice, the Office of the Inspector General, the Health Care Finance Administration, and virtually every Medicaid Fraud Control Unit in the United States.
Business Experience
Ken’s business experience since leaving law enforcement includes:
- Engagement leader for various Corporate Integrity Agreements
including training, billing engagements, and compliance engagements.
- Performed
Voluntary Disclosure engagements for various types of providers.
- Performed
risk assessments and diagnostic reviews of various types of providers
in connection with investigations of
compliance issues associated with numerous federal and state healthcare
programs.
- Developed, implemented and monitored compliance
programs in a variety of healthcare settings, from stand-alone
facilities to multi-state systems.
- Provided compliance training for large
hospital systems and physician groups.
- Performed “shadow audits” and
internal investigations in response to government intervention activities
and compliance
program monitoring in a variety of healthcare provider settings.
- Performed assessments of hospital Medicare billing systems in connection
with issues regarding supervision of resident
services.
- Performed evaluations of physician group billing
practices associated with hospitals.
- Participated in settlement
negotiations with various United States Attorneys’ Offices, the Office
of Inspector General,
and certain Medicaid Fraud Control Units on behalf of providers.
- Assisted with the development of Fraud Prevention Plans and Special Investigation Units for healthcare payers.
Education and Training
- Ken received his Bachelor and Master of Arts degrees with
honors from Purdue University in West Lafayette, Indiana and his Juris
Doctorate degree with honors from Indiana University School
of Law in Indianapolis, Indiana.
- He has published healthcare fraud related
articles for Compliance Today, the American
Bar Association, the National Association of Attorneys General,
Journal of Health Care Compliance, Healthcare Business, Chicago Daily Law
Bulletin, Law Bulletin Information Network, and Checklist to Compliance.
- He has made topical healthcare presentations at meetings sponsored by the American Bar Association, Federal Bureau of Investigation, National Association of Medicaid Fraud Control Units, National Health Care Anti-Fraud Association, Health Care Compliance Association, Corporate Compliance Forum, Healthcare Financial Management Association (and various State chapters), Professional Liability Underwriters Society, International Business Communications, Indiana Health and Life Association, Illinois CPA Society, National Congress on Health Care, and various State Bar Associations.
