Investigations & Disputes | Healthcare | FTI Consulting
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Investigations and Disputes

FTI Consulting has played a significant role in many of the best-known and most substantial healthcare investigation and litigation matters, including False Claims Act cases, Stark Law and Anti-Kickback Statute investigations, business disputes and other issues. We have testified as expert witnesses at trial and deposition in federal and state proceedings, before administrative bodies, and in bankruptcy and tax court. Our nationwide team includes seasoned healthcare professionals with expert credentials in accounting, finance, economics, valuation, complex data analysis, computer forensics and fraud investigations. These experiences enable us to play an invaluable role in strengthening client operations and protecting assets and reputations. We provide proven and cost-effective solutions based on benchmarking, advanced statistical sampling, development of complex industry and company-specific databases, and sophisticated risk assessment techniques.

Our Services

Medicare, Medicaid, and Other Federal and State Healthcare Program Investigations

We have assisted a wide variety of healthcare clients including hospital systems, pharmaceutical companies, electronic health record (EHR) software vendors, inpatient rehabilitation facilities, skilled nursing facilities, home health companies, device manufacturers, and payers in conducting internal investigations related to Medicare and Medicaid false claims and fraud and abuse issues. As part of these investigations, FTI Consulting regularly assists clients and their counsel in discussions with the DOJ, OIG, state Medicaid and regulatory agencies, and the SEC.

Litigation and Commercial Disputes

We have assisted a variety of clients and their outside counsel as expert witnesses and privileged consultants in nationwide class-action matters, federal and state court litigation, international arbitration, and arbitration and mediation matters.

Data Analysis and Benchmarking

We leverage clients’ enterprise data and relevant industry data to develop analytics that drive insights in investigations and litigation, proactively identify and contextualize compliance issues, and foster organizational improvement.

Clinical Insights and Analysis

Our multidisciplinary team includes nurses, clinicians, physicians, coders and other experienced healthcare professionals. We leverage our clinical experience in matters involving medical necessity of care; analysis of billing, coding, and reimbursement issues; and other federal and state healthcare program coverage and healthcare compliance issues.

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