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Healthcare fraud and False Claims Act expert witnesses

Expert class library · 2 classes

The statisticians, coders and clinical reviewers in False Claims Act and healthcare fraud cases: sampling, extrapolation and medical necessity.

Each class is defined by role and method, never by a person or a firm. Open one for what its testimony turns on, how it is attacked, and the rulings, each summarised from the opinion and linked to it.

Retained by either side

FCA statistical sampling and extrapolation expert

Probability sample design (RAT-STATS) · Stratified random sampling

Medical coding and billing auditor

CPT and E/M level review · NCCI edit analysis

Recent rulings

The 6 rulings in this practice, newest first. Each links to the free opinion on CourtListener and to the class it belongs to.

OutcomeCaseCourtExpert class
AdmittedRupp v. Premier Health Partners2025-Ohio-985Ohio Ct. App. 2025Medical coding and billing auditor
AdmittedGrant v. Zorn107 F.4th 7828th Cir. 2024FCA statistical sampling and extrapolation expert
AdmittedUnited States v. Allied Home Mortgage Corp.933 F.3d 4685th Cir. 2019FCA statistical sampling and extrapolation expert
LimitedUnited States v. Long Grove Manor, Inc.315 F. Supp. 3d 1107N.D. Ill. 2018FCA statistical sampling and extrapolation expert
AdmittedUnited States v. Brown871 F.3d 3525th Cir. 2017Medical coding and billing auditor
LimitedUnited States ex rel. Johnson v. Golden Gate National Senior Care, L.L.C.223 F. Supp. 3d 882D. Minn. 2016Medical coding and billing auditor

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The library summarises public decisions for orientation; it is not legal advice. Read the opinion before relying on any ruling. No individual expert is named.

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