Healthcare

Expert Services

At Ankura, we have a deep bench of expert witnesses across many disciplines in the healthcare and life sciences industries. Our professionals include former industry executives, federal prosecutors, and health plan compliance officers. We also have experts in compliance, forensic accounting, financial damages, valuation, clinical billing and coding, healthcare reimbursement, economics, and other disciplines. Our experts have been closely involved in high-profile issues facing life sciences and healthcare organizations over the past few decades and can provide testimony that distills the key concepts of a dispute.

Our experienced testifiers have served as expert witnesses for healthcare entities in federal and state courts; confidential arbitrations; as well as before government regulatory agencies, on a wide range of issues arising from contract disputes, shareholder disputes, class-action lawsuits, government investigations, qui tam actions, and other civil or criminal disputes. We are frequently called upon to serve as experts in the areas of damages analysis, valuation, class certification, industry customs, and medical billing and coding reviews.

Solutions

  • Quantification of damages
  • Breach of contract payment and coverage disputes
    • Out-of-network payment/reasonable value disputes
    • Risk adjustment/risk-based payment disputes
  • Billing and coding reviews
  • Medical necessity and length of stay evaluations
  • False Claims Act, Stark Law, Anti-Kickback Statute lawsuits
  • Operations and claims adjudication processes, systems, and standards
  • Compliance program effectiveness (Part D, Medicaid, etc.)
  • Patent infringement lawsuits
  • Off-label sales and marketing lawsuits
  • Class certification
  • Valuations