Fraud and Abuse Investigations
EisnerAmper helps legal counsel both investigate and defend health care providers, of all sizes and structures, facing regulatory, criminal or civil actions.
Based on deep-rooted industry knowledge and specialized experience from the firm’s health care industry and forensic, litigation and valuation service groups, we implement time-tested methodologies to identify and evaluate patterns, anomalies and variances.
From performing detailed analyses and developing comprehensive case strategies to preparing government presentations and compiling detailed data lists for damage claims, we partner with health care attorneys as a specialized resource throughout the entire legal process.
Through our in-depth analysis, data mining and analytical methodologies specifically designed for each matter, we identify and extract key elements and patterns central to your legal issues. By taking a deep analytical dive into large claims and related datasets, medical records, revenue metrics, coding billing, reimbursement, Medicare/Medicaid issues and more, our dedicated health care professionals have deep experience in reviewing, uncovering and refuting assertions.
We use this information to establish a reliable analysis of all case issues, particularly in connection with cases that involve coding irregularities, billing errors, reimbursement concerns and other relevant matters designed to foster practical, leading-edge solutions.
Our team is comprised of diverse groups of highly specialized professionals from the health care, forensic and accounting spaces. Team members include former executives, regulators, IT and digital specialists, clinicians, medical records analysts, and certified billing and coding professionals in the health care industry as well as experienced accountants, financial statement auditors, valuation analysts, fraud investigators, and bankruptcy and restructuring experts.
With our deep experience and advanced tools, we’re equipped to assist on either plaintiffs’ or defendants’ side of health care cases.
Rethinking Fraud and Abuse Investigations
It’s our mission to provide comprehensive and effective solutions for our clients:
- Federal False Claims Act Violations
- Stark Law Violations
- Anti-Kickback Statute Violations
- Regulatory and Enforcement Investigations
- Whistleblower Actions Case Development and Response
- Internal Investigations
- Criminal Fraud Defense
- Governmental Civil and Criminal Actions
Fraud and Abuse Investigation Services
Our practical solutions are based on analytics and in-depth industry insights:
- Health Care Litigation Support
- Expert Witness Services
- Initial Investigation/Claim Analysis
- Presentation/Evaluation of Preliminary Findings
- Scope and Methodology to Complete Analysis
- Presentation to Regulators/Department of Justice
- Enterprise Improvement
- Resolution Process
- Expert Witness Testimony
- Compliance/Monitorships
Our Clients
As a trusted partner of the industry, our team provides comprehensive and impactful solutions to help you tackle the most pressing challenges across the entire health care spectrum:
- Legal Counsel, Law Firms and Health Care Attorneys
- Health Care Providers
- Attorneys
- Government Payers (Medicare, Medicaid)
- Health Plans
- Commercial Payers
- Owners and Investors
- Private Equity Firms
What's on Your Mind?
Start a conversation with the team