Fraud Waste and Abuse Claims
In the area of fraud waste and abuse, TD&P and its experts:
- Provide consultation and expert testimony on matters involving pricing and reimbursement policies.
- Leverage their in-depth knowledge of the health care industry, as well as its pricing and statistical expertise, to evaluate allegations including, among other things, kickbacks leading to medically inappropriate provision of goods and services, inappropriate referrals, deceptive marketing, up-coding, or fraudulent billing practices.
- Work with clients to design analyses tailored to the industry-specific facts and circumstances of each case and develop damages models that are grounded in robust methodologies and that reflect market realities.
- Work with key health care data sources and rely on sound healthcare policy and financing theory, as well as medical pricing expertise, to analyze the merits of damages questions.
- Use their in-depth understanding of the health care sector including hospitals, physicians, health insurance, PBMs, pharmacies, pharmaceuticals, clinical laboratories, dialysis services, ambulance transport, and nursing homes to make expert cost determinations.