Today’s compliance and risk management challenges require innovative solutions.
LWCI has the expertise and experience to achieve them.
LW Consulting, Inc. (LWCI) is a recognized leader in providing compliance, reimbursement, operational, and clinical consulting solutions across the full continuum of healthcare delivery.
We are an Independent Review Organization (IRO), performing audits under Corporate Integrity Agreements (CIA), and an expert resource to providers, attorneys, and government agencies in ensuring organizations meet the myriad of guidelines, requirements, and statutes that regulate the delivery of healthcare services. We also provide interim staffing for post-acute care providers.
Suite of Services
Our team includes compliance professionals, reimbursement experts, RNs, therapists, auditor-coders, and consulting physicians. Many team members possess numerous industry certifications.
Our clients receive peace of mind knowing that they have received reliable advice and guidance that improves their business.
We often work with attorneys for providers in negotiating with the MACs, the OIG, federal prosecutors, US Attorneys and State Agencies in evaluating medical necessity, coding and billing procedures, and negotiating the adjudication of potential overpayment, denials, and disputed claims.
LW Consulting, Inc. uniquely blends its comprehensive knowledge of the healthcare industry with a proven ability to work as a partner with healthcare attorneys. We understand the ebb and flow of the legal process. We are flexible, responsive, and complete our work when and where it is needed.
What is the RCD? The Review Choice Demonstration (RCD) project for Inpatient Rehabilitation Facilities (IRF) seemed like a pipe dream when the Centers for Medicare & Medicaid Services (CMS) started discussing it before the Pandemic. The goal of the RCD is to reduce the burden on providers demonstrating compliance with Medicare IRF rules. The RCD started out slowly, but is currently in full swing in four states: Alabama (effective August 2023) Pennsylvania (effective June 2024) Texas
Glucagon-Like Peptide-1 (GLP-1) medications have largely been discussed as a pharmaceutical and clinical story. Increasingly, however, they are becoming a healthcare strategy story. A recent Wells Fargo analysis highlighted by Fierce Healthcare suggests that widespread GLP-1 use could disrupt a healthcare system that has historically invested significant resources in treating the downstream consequences of obesity (Fierce Healthcare, 2026). As treatment moves further upstream, healthcare organizations may need to reconsider everything from service-line projections and utilization
Another day, another False Claims Act (FCA) allegation—and this time, it’s a big one. The U.S. Department of Justice (DOJ) announced a healthcare provider agreed to a settlement exceeding $541 million to resolve allegations that unsupported diagnosis codes were submitted to Medicare Advantage Organizations, resulting in inflated payments from the Medicare program. According to the DOJ, the alleged conduct involved diagnosis codes that lacked sufficient documentation in the medical record or were based on improper
“The manner in which LW Consulting conducted our organization’s board retreat this past January, was both professional and personal. All participants were energized and inspired. As a result, during the board meeting that followed in March, every member was empowered to speak on the issues at hand. For the first time, we had generative discussions that moved the ball forward with action steps assigned to individuals or groups. Absolutely ground-breaking for our organization and we continue to reap the benefits.”
Dana Chandler
Ensign Services
“As we began the process of selecting our IRO, we wanted to engage a company that had an auditing team with real world experience. We wanted accurate and trustworthy results that could add value to our rehabilitation, nursing and MDS programs. We have found that with LW Consulting. The LW team is professional, seasoned, and experienced. The therapists and nurses evaluating our teams and documentation understand the skilled nursing and therapy world. Many of them continue to work as on-call therapists. Their guidance and evaluation skills are founded in the real world of caring for our senior population. Our staff find the LW team to be genuine, knowledgeable, respectable and approachable. Once our IRO relationship ends with LW Consulting, we hope that we will be able to continue to utilize them in a consulting capacity for many years to come.”
Deborah M. Miller RN, JD Chief Compliance & Privacy Officer
Urology Care Alliance
“We have used the services of LW Consulting for the last three years for chart review audits and follow-up training of our 25 physicians. We are extremely pleased with thoroughness and quality of the work that they have done. They have provided both individual feed-back sessions with some of our physicians as well as webinar review and training sessions that all of our physicians attended.”
