In compliance and litigation settings, we are routinely confronted by an opposing party alleging some form of inappropriate conduct. Disputes often arise involving overpayment allegations, audits of insurance claims, or purported false claims and any of these allegations may invoke…

In compliance and litigation settings, we are routinely confronted by an opposing party alleging some form of inappropriate conduct. Disputes often arise involving overpayment allegations, audits of insurance claims, or purported false claims, and any of these allegations may invoke…

There is considerable hesitancy in the healthcare industry to rely on statistical sampling for questions deemed subjective in nature, or when the sampling units in a population might be considered too unique.  This generally manifests when attempting to extrapolate liability…

While many providers repay millions of dollars to CMS recovery audit contractors (“RACs”), a growing number are employing successful appeal strategies, allowing them to overcome the government’s demands and retain their revenue … appealing overpayments and demands for overpayment