Applied Statistical Data Sciences
Our Service Offerings
- Expert Testimony
- Fraud Detection
- Class Certification
- Data Management & Construction
- Data Analytics
- Data Visualization
- Statistical Data Science Modeling
- Statistical Sampling and Surveys
- Insurance Claims Data Analytics
- Healthcare Litigation & Audits
- Financial Markets
- Labor & Employment Litigation and Compliance
Modern litigation often involves enormous amounts of data and requires sophisticated statistical analyses to develop and support expert testimony. At the same time, the data sciences landscape is continually evolving with ever-changing database and computing platforms creating an alphabet soup of tools and solutions. The FTI Consulting Applied Statistical Data Sciences team has experts who are experienced in the complex data and statistical issues inherent in modern litigation and business analytics. We are aware that complex data analysis is only meaningful or helpful to others when the results are fully understood, so we also employ data visualizations or infographics to make our results clearer to decision makers.
The Applied Statistical Data Sciences team at FTI Consulting relies on a number of advanced analytical methods to detect fraud. We apply our expertise to consolidate large, disparate sources of data and to perform rigorous analysis on the consolidated data to identify anomalies that help us detect fraud. For cases pertaining to the False Claims Act, our use of innovative techniques has revealed unexpected, yet systematic relationships among physicians and other providers with respect to common billing and claim submission patterns. These systematic relationships have been used to make fraud detection more efficient, and, in litigation proceedings, to show the interconnectedness of fraud participants.
Our practice utilizes advanced data visualization techniques, such as social network analysis, to uncover indicia of fraud. Social network analysis maps and measures the relationships and interactions between potentially connected entities, such as people and/or organizations. Social networks play a big role in an organization’s business practices, and the success of a business idea often depends on the network of information flows and knowledge interactions.
Social networks are not just found within organizations but also exist between them. For example, a doctor’s professional network will influence his portfolio of procedures performed, his drug prescription decisions and the other doctors to whom he refers patients. Today’s world is more connected than ever, and, to this end, we are constantly embracing new algorithms, methods and metrics in applying social network analysis to business problems and opportunities, as well as to forensic investigations and litigation.
We work closely with teams of attorneys to design network analyses and sampling techniques to develop statistically reliable results for pre-class certification phases, class decertification phases and large multidistrict litigation cases. In a recent environmental nuisance litigation, our team employed mass appraisal methodologies utilizing advanced techniques to control for factors affecting home prices, such as square footage. Also, we utilized geotagging and spatial autocorrelation to improve the model’s performance for unobserved factors, such as being close to an industrial site, playground or park. Our team has provided expert testimony in dozens of class action matters during the class certification phase.
Data Management & Construction
The FTI Consulting Applied Statistical Data Sciences team regularly works with pools of data containing billions of records. We use our secure computing facilities that allow our teams to manage, maintain, update and query large private and highly confidential datasets used to support management’s regulatory decisions. Clients and their counsel rely on our team to assemble large datasets from disparate sources and discordant formats. These cutting-edge resources combined with our expertise ensure data integrity over the potentially long-range horizon of litigation, regulatory or investigation projects.
Big data analytics has become a given in many sectors, especially in the healthcare industry. Patient and insurance claims data are challenging to manage and are typically presented as a combination of structured and unstructured data which are, at times, incomplete. These data may contain key insights that can be used to provide pivotal support in litigation matters when analytics are properly applied. Our Applied Statistical Data Sciences team specializes in solving data issues using advanced predictive modeling and Bayesian methods to provide creative “out-of-the-box” analyses to tell the most accurate and straightforward story needed for expert testimony.
Big data and visualization go hand-in-hand. We transform “difficult to manage” structured and unstructured data, while preserving its integrity, into visualizations that quickly and efficiently identify and display data abnormalities and key trends. These visualizations can be used to identify fraudulent behavior between groups of people and can display complex data in easy to digest diagrams. Using these visualizations, we convert data into strategic information for our clients.
The FTI Consulting Applied Statistical Data Sciences team uses an array of visualization tools, ranging from Tableau and Gephi to D3 and Python, to provide insights needed to make informed, fact-based decisions using complex data.
Statistical Data Science Modeling
The FTI Consulting Applied Statistical Data Sciences team is comprised of experts in unifying the fields of mathematics, statistics, information science and computer science to understand and analyze actual phenomena with data. We have extensive experience using the sophisticated statistical data science techniques, such as regressions and social network analysis, in both litigation and non-litigation contexts. Examples of our expertise include:
- Financial Litigation: We are experts at creating “event studies” to quantify “abnormal” stock price behavior, controlling for changes in the overall stock market, industry and best comparable firms.
- Antitrust and Competitive Markets: We evaluate the impact of alleged anticompetitive conduct of business practices and proposed mergers.
- Labor & Employment: We specialize in preparing economic and statistical analyses for clients facing wage and hour, class action, class certification, lost earnings and discrimination issues. Our team can assist clients in all phases of the litigation cycle from discovery, data gathering, preservation of data and analysis to expert witness testimony.
- Healthcare Claims & Fraud Detection: We evaluate illicit behavior in healthcare claims litigation ranging from providers overcharging payers to payers underpaying providers. We have successfully converted reference-based healthcare claims data into a complete image of provider behavior with insights into fraudulent billing schemes that were sophisticated, pre-determined and coordinated.
- Environmental Damages: We are involved in many large data and statistical intensive environmental damages cases involving quantifying damages associated with nuisance as well as cases involving the diminution of real estate value due to an environmental event.
Statistical Sampling and Surveys
We have experts in designing and implementing litigation and regulatory-ready statistical samples and surveys. Our team specializes in assessing and critiquing the sampling and survey methodologies of opposing experts, particularly in healthcare-related litigation, audits and regulatory proceedings.
Our experts are routinely involved in high profile sampling cases in areas such as False Claims Act, medical claim adjustments, fraud investigations, financial instrument analysis, employment disputes, intellectual property theft, construction claims and environmental remediation.
We have critiqued and submitted expert reports on sampling and extrapolation methodologies of opposing experts in high profile False Claims Act cases relating to healthcare and construction claim overpayments. For example, a seminal sampling case, the United States ex rel. Wall v. Vista Hospice Care, Inc., No. 07-cv-00604 (N.D. Tex. June 20, 2016), in which the opposing expert’s sampling methodology was found to be flawed, and the extrapolated damages were wholly rejected by the court.
Team members are also experts in creating well-designed, litigation-ready and thoughtful statistical surveys that provide insight into litigation and corporate decision-making. We utilize the latest statistical and data science techniques to isolate and measure the factors that are relevant to the determination of damages; liability in numerous types of litigation or in non-litigation settings, such as making labor and employment decisions; or pricing and product strategies.
Insurance Claims Data Analytics
Modern healthcare disputes involve collecting and analyzing large medical claims databases. FTI Consulting Applied Statistical Data Sciences team members are experts in dealing with these complex litigation cases requiring data management, digitization and analyses of complex and large datasets. We regularly analyze datasets containing hundreds of millions and even billions of records. Our expert staff and state-of-the-art secure computing facilities can efficiently and swiftly handle computations on these large datasets required for expert testimony in litigation cases or regulatory and internal investigations.
Our professionals work closely with general counsel of major insurance companies and their outside counsel on complex damage calculations for purposes of settlement negotiations and expert testimony. Our team has also assisted with projects involving catastrophic reinsurance coverage, RMBS exposure and prescription drug coverage, as well as assessing the systematic risk to a healthcare insurer for a large group of New York City employees. Results of our advanced statistical methods have led to the discovery of previously unseen risks that were not captured in classical regression analysis.
Healthcare Litigation & Audits
We provide consulting and expert testimony to payers, providers and counsel involved in litigation or healthcare audits. Our Applied Statistical Data Sciences team brings unique insights and solutions to these audit and litigation problems by visualizing and capturing the complex relationships in healthcare data and providing solutions traditional analyses fail to capture. Typical applications include developing or critiquing statistical sampling, class actions, UCR (“Usual, Customary and Reasonable”) and assisting in common types of healthcare fraud, including false medical certification, p-coding and unbundling, medical necessity, self-referrals, services not rendered and prohibited services rendered.
Life sciences firms are often at the center of False Claims Act disputes, allegations of unlawful sales and marketing practices, improper pricing, discounting and violations of Anti-Kickback Statutes. Our team members are experts in assisting with these matters, particularly reimbursement-related matters on issues of liability, impact, damages and class certification. These matters include:
- False Claims Act and Anti-Kickback Statute investigations
- Disputes between payers and healthcare providers
- Healthcare audits – Medicare and Medicaid
- ZPIC, RACs, MICs, MACs
- Assistance in defending and understanding government audits and overpayment extrapolations
- Statistical extrapolation of overpayments
- Billing and coding review
Our team assists companies, counsel and forensic accountants with investigations involving insider trading and market timing allegations. Typical analyses evaluate communications and trading patterns over time to determine if profitable trading is consistent with the allegations. Family members, friends and close affiliates are also analyzed with respect to the specific timing of extra-normal returns from investments. We have designed financial models estimating the economic damages to shareholders caused by the alleged fraudulent activity of insiders and rogue traders. Some of these models have incorporated the network effects of the number of interconnected investors when estimating damages.
Labor & Employment Litigation and Compliance
The FTI Consulting Applied Statistical Data Sciences team specializes in preparing economic and statistical analyses for clients facing disputes and compliance actions relating to wage and hour issues, class action, class certification, lost earnings and discrimination. Our team has deep labor and employment experience managing the ever-increasing size and complexity of human resources, payroll, personnel and timekeeper databases. With our highly trained and seasoned professionals, we are able to quickly and effectively utilize our specialized network analysis to improve visualizations and statistical analyses. This allows us to both identify and quantify potential damage exposures that other, more traditional analyses simply miss.
Senior Managing Director
- FTI Journal Article: How Creative Web Scraping Played a Key Role in a Medicaid Arbitration Case
- White Paper: Healthcare Audit Metrics
- Brochure: Statistical Sampling & Network Analysis
- Case Study: Network Analysis – Detection of Fraud, Waste & Abuse
- Brochure: Healthcare Economics Advisory Services Brochure