For many years, the government and qui tam relators have employed various statistical models to estimate damages in Medicare fraud and other False Claims Act cases. It is now a well-established way to prove damages.
For example, in late 2014, a District Court in Tennessee ruled that extrapolation from a small sample of 400 claims can be used to establish FCA liability for a universe of over 150,000 claims. In that case, the defendant-skilled nursing home facility sought to compel discovery from the government for allegedly false claims outside of the government’s sample. The court rejected the defendant’s motion in a recent opinion, U.S. ex rel. Martin v. Life Care Centers of America, Inc., No. 08-cv-251 (E.D. Tenn. Feb. 18, 2015). The court stressed that allowing the defendant to conduct discovery as to claims outside of the government’s sample would require the very claim-by-claim review that the court previously determined to be unnecessary for establishing FCA liability.
More information for whistleblowers is located at the Nolan Auerbach & White website.