CRA was retained on behalf of a practice management software company facing False Claims Act allegations that its software was biased to encourage provision of healthcare services. Relator proposed a statistical sampling methodology to demonstrate liability in a bellwether trial, but CRA analysis demonstrated that the proposed methodology itself was significantly biased. In addition, CRA refuted expert reports from a statistician (proposing alternate sampling methods), a reimbursement specialist (regarding billing and reimbursement mechanisms and whether they could be affected by the alleged behavior), and a medical coding expert (regarding the link between treatment recommendations and actual billed services). The case resolved with summary judgement against the Relator.
How to use generative AI for pricing
By lowering technical and financial barriers, these tools democratize access to sophisticated pricing capabilities, empowering even small businesses to benefit...