health care
Industries

Healthcare Fraud & False Claims

Healthcare and life sciences companies and their counsel turn to us for investigations and disputes relating to fraud, qui tam and false claims matters, Stark/anti-kickback, and voluntary self-disclosures. We can also serve as an Independent Review Organization (IRO) or an Independent Monitor. Our industry knowledge and expertise in economics, finance, accounting, and business strategy make us uniquely qualified to assist in all phases (i.e., class certification, merits, causation, and damages) of these matters.

  • Provide consultation and expert testimony in fraud and False Claims Act matters involving promotion, marketing, pricing, reimbursement, and distribution policies.
  • Leverage our experts’ economics and statistical expertise to evaluate allegations including, kickbacks leading to medically inappropriate provision of goods and services, inappropriate referrals, up-coding, unbundling, deceptive marketing, promotion of drugs for off-label uses not approved by the FDA, fraudulent billing practices, or retention of overpayments.

Engagements

  • 01
    FCPA investigation at a medical device company
    CRA was engaged by a medical device company that needed to investigate allegations of bribery in India. The company was in the process of selling its Indian...
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  • 02
    Investigation of Medicare claims payment processor
    Members of CRA’s team were hired to investigate a payment processor of Medicare claims related to home health aides in approximately 27 states. The team was...
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  • 03
    Hired to analyze the fair market value of services
    Retained to analyze the fair market value of services provided by an affiliate-owned provider of oncology-related services in order to effectively address and...
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