The latest edition of K&L Gates’ Qui Tam Quarterly addresses key strategies for defending allegations supported by extrapolated overpayments and some best practices for using claims data to proactively defend against scrutiny. Specifically, information and recommendations are provided on how to undermine the validity of findings on a sample set of claims that can be used to invalidate the extrapolated assumptions, how to effectively challenge an extrapolation based on improper sampling and auditing processes, and how to dispute the statistical extrapolation process after an extrapolated overpayment has been asserted against a provider. Finally, resources and suggestions are provided on how providers can take advantage of currently available claims data to reduce the risk of scrutiny.
