In order to prove liability, our Health Care Cost Containment Practice, under the direction of Howard Pierce, has pioneered the design and application of regression analysis with statistical analytics using outside Ph.D. consultants and statistical experts in Healthcare economics. The Practice’s approach is straightforward, effective and unconstrained by geographical boundaries. We represent health care payers, property/casualty insurers and self-funded plans in a variety of claim cost containment cases against individuals, laboratories, pharmacy benefit programs, national medical providers, hospitals, urgent care centers, medical clinics and others engaged in fraud. The Practice works closely with prosecutors around the country in pursuing both civil recoveries and seeking criminal penalties for fraudulent providers, as well as obtaining restitutional awards for our clients. Most recently, the Practice has been able to identify massive Covid overbilling schemes by showing upcoding of Covid testing claims through data analytics and witness interviews of former employees and patients.
To date, the Practice has recovered over 14.4 million dollars on behalf of the United States Government and State Governments and over 248 million dollars for over two dozen commercial group healthcare and property casualty payers and Taft-Hartley Benefit Funds arising from abusive healthcare claim practices.
The defining elements of the Practice are its history, covering over three decades of success in and out of the courtroom, its ability to design creative and cost-effective legal strategies to obtain early and decisive victories and favorable settlements and its close working relationships with clients. These elements allow them to work as a team, with an intrinsic understanding of the clients’ definition of a successful outcome.