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Inman writes on whistleblower case brought by outsider

Posted  August 30, 2018

Constantine Cannon partner Mary Inman published an article in RAC Monitor about a lawsuit brought against Providence Health & Services and its consultant J.A. Thomas and Associates LLC (JATA) by Integra Med Analytics LLC, a data analysis firm that uses statistical analysis of publicly available data to attempt to uncover and prove fraud. Integra alleged that it analyzed seven years’ worth of publicly-available claims data from Providence hospitals that used JATA as a consultant, and found that those Providence hospitals were statistically more likely than other hospitals to add certain identified diagnoses that increased payments to the hospital.  In addition to this statistical analysis, Integra also alleged that it conducted its own independent investigation, interviewing employees and obtaining non-public information.  Inman’s RAC Monitor article details the potential significance of Integra’s approach, and argues that such outside whistleblowers are becoming more common.

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Tagged in: FCA Federal, Hospital Fraud, Upcoding, Whistleblower Case, Whistleblower Eligibility,