In a case in which it chose not to intervene, DOJ has stepped in to defend the relator’s attempt to use statistical sampling to prove FCA liability.
The relators allege that a nation-wide healthcare provider violated the FCA by making medically unnecessary admissions and false diagnoses to increase reimbursements at a facility in Indiana. They proposed using statistical sampling to establish FCA liability based on evaluation of a subset of medical records from facilities throughout the country. The magistrate judge rejected the relators’ claim on the grounds that “fraud will have to be proved on a claim-by-claim basis.”
However, the DOJ has submitted a Statement of Interest arguing that the judge’s dismissal should be set aside, “because it is contrary to long-established precedent recognizing statistical sampling as an admissible and valid method of proof in complex cases involving large numbers of claims, including cases brought under the FCA.”