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A veteran practicing physician, Charles consults with the firm’s Healthcare Industry Team on Medicare Administrative Contractor (MAC) and Recovery Audit Contractor (RAC) audits.
Dr. Charles H. Whigham is a member of Womble Carlyle’s Healthcare Industry Team as a Consulting Physician. Dr. Whigham assists the team’s attorneys and staff in helping healthcare clients respond appropriately to audits of their services by government agencies and/or government contractors, such as Medicare Administrative Contractors (MACs) or Recovery Audit Contractors (RACs). In this capacity, he works closely with Womble Carlyle attorney Tracy Field, the former Executive Vice President of Compliance and Government Appeals for Piedmont Healthcare, Inc., and leader of the firm’s Healthcare Industry Team in Atlanta. Dr. Whigham has extensive experience dealing with healthcare audit-related issues, having previously served as the Medicare Part B Carrier Medical Director for Georgia (while working with Aetna and with Cahaba GBA), and as a Medical Director with a Medicare Quality Improvement Organization (Georgia Medical Care Foundation). He also has previously worked as a Medical Director with a Medicaid Integrity Contractor. Most recently, Dr. Whigham served as Medical Director/Chief Medical Officer with Healthcare Management Solutions, LLC. Additionally, he worked as a private consultant from 2003 to 2007 assisting healthcare providers and their attorneys with issues related to government audits of their services. He is Board Certified in Internal Medicine and has years of clinical practice experience.
Medical Director/Chief Medical Officer, Healthcare Management Solutions, LLC (HMS), 2011-2012;
Corporate Medical Director, PRGX Global Inc., 2010-2011;
Physician Advisor, Arnall Golden Gregory LLP, April - September 2010;
Medical Director and Vice President for Program Integrity, Healthcare Management Solutions, LLC, 2008-2010;
Medical Director for Program Integrity and Compliance, Georgia Medical Care Foundation, 2007-2008;
President, Charles Whigham, M.D. and Associates, Inc., 2003-2007;
Medicare Part B Medical Director for Georgia, Cahaba Government Benefit Administrators, a Division of Blue Cross and Blue Shield of Alabama, the Medicare Part B Carrier for the State of Georgia, 2002-2003;
Medical Director, Georgia Medical Care Foundation, 1996-2002;
Vice President of Medical Affairs, MedQual, Inc. (a wholly-owned subsidiary of the Georgia Medical Care Foundation), 1996-1999;
Lead Medicare Medical Director for Aetna Health Plans, Aetna, Inc., 1995-1996;
Private Practice of Internal Medicine, Appling County, Georgia, January 1995 – August 1995;
Associate Medicare Medical Director with Blue Cross and Blue Shield of Florida, February 1994 – December 1994;
Medical Director for the Part B Medicare Program in Georgia, Aetna Health Plans, 1991-1993;
Associate Medical Director, Blue Cross and Blue Shield of Alabama, 1989-1991;
Primary Care Internist, Kaiser-Permanente HMO, Atlanta, Georgia, October 1988 – February 1989;
Private Practice of Internal Medicine, Waycross, Georgia, 1985-1988;
General Practice of Medicine, Woodbine, Georgia, 1979-1982.