Bernard K. Hooper

RELEVANT EXPERIENCE

Bernard Hooper trained at Mintz Levin and LeBoeuf Lamb, where he built a strong foundation in corporate and commercial law. He later served as Director of Legal Affairs for the Asia, Pacific, and Africa regions at Ford Motor Credit Company, overseeing complex cross-border matters and advising on international business operations.

In more recent years, he has transitioned his focus to the healthcare industry, serving as a Chief Administrative and Chief Compliance Officer for a $500 Million Prepaid Inpatient Health Plan. In this capacity, he has guided organizations through the evolving regulatory landscape, bringing together his corporate law expertise with practical compliance experience to support integrity, accountability, and continuous quality improvement and the provision of service suitable for the condition of more than 30,000 individuals with severe mental illness, substance use disorder, and intellectual/developmental disabilities.

REPRESENTATIVE MATTERS

In recent years, Bernard has been immersed in the healthcare industry as a C-suite executive and compliance professional. He has engaged in numerous investigations regarding allegation of fraud, Conflicts of Interest, harassment, policy and regulatory violations. He has substantial experience with employment matters involving both union and non-union disciplinary and termination processes. He has expertise in the False Claims Act (FCA), HIPAA, 42 CFR part 2, and Medicaid regulations. Bernard has directed recoupment matters under FCA involving millions of dollars and has frequently used extrapolation is the review of voluminous claims to identity potential patterns of non-compliance and engage in reporting and negotiation with state authorities such the Office of Inspector General and the Office of the Attorney General. He has designed and conducted data mining exercises to assess the validity of claims submission and adjudication. He also has designed and managed a claims department which handled more than $50 Million annually. In addition, Bernard has expertise in managing significant breach matters under HIPAA, including matters involving Business Associates Agreements, and has remediated numerous privacy matters including the sharing of PHI and de-identified data with universities and law enforcement agencies. Bernard has substantial experience with quality certification organizations including the National Committee for Quality Assurance (NCQA).  

Bernard understands and excels in cross-functional teams and offers a unique blend of innovation and experience in many situations. He regularly negotiates commercial matters in support of executive management teams and offers a strong understanding of finance, economics, and legal issues.