Courts have generally accepted statistical sampling and extrapolation as evidence to estimate damages.[i] However, the use of sampling for purposes of establishing liability in False Claims Act (“FCA”) litigation is an issue of conflict between those prosecuting FCA claims and those defending such claims. In the decision in United States ex rel. Martin v. Life Care Centers of America, Inc., the Eastern District of Tennessee found sampling and extrapolation appropriate for the Government’s use in attempting to establish the elements of FCA liability.[ii] While that case settled for $145 million in 2016, this post offers an overview of the case, along with a summary of the Court’s decision and a discussion of its implications…

While many providers repay millions of dollars to CMS recovery audit contractors (“RACs”), a growing number are employing successful appeal strategies, allowing them to overcome the government’s demands and retain their revenue … appealing overpayments and demands for overpayment