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Statistical sample analyzed as part of insurance litigation
ERS Group was retained by a national insurance company to review a statistical sample of claims that was used as the basis for a law suit against the company. The law suit dealt with the issue of how the company historically compensated attorneys hired by its policyholders when the company had subrogation claims.
Internal study of claims helps detect potential insurance fraud
ERS Group was retained by a major insurer operating in Southern California to review claims contained in several massive databases with a view toward determining if insurance fraud was occurring. The insurer provided ERS Group economists with data pertaining to auto accidents, claimants, medical clinics, treating physicians and attorneys. The ERS Group analysis detected a number of patterns in these data related to certain types of accidents, treatment locations, attending physicians, and filing attorneys, that were unknown by the insurance carrier prior to the analysis. Upon completion of our work, the insurance carrier brought highly publicized lawsuits against some of the worst offenders discourage future staged accidents and fraudulent claims.
Examination of potential fraud in Florida’s Supplemental Nutrition Assistance Program (SNAP)
ERS Group economists worked with the state to prepare an analysis of potential fraud in Florida’s SNAP program. ERS Group developed an economic and statistical model of the program to measure the potential amount of fraud, waste and abuse in the SNAP program. Upon completion of the analysis, ERS Group’s expert produced a written report to the State of Florida Chief Financial Officer and Florida Department of Children and Families, and presented the finding before the Medicaid and Public Assistance Fraud Strike Force.
Review of expert testimony on behalf of state involved in Medicaid litigation
ERS Group was retained as consulting experts by a large, Southern state for a Medicaid matter that was in trial. ERS Group’s experts reviewed literature related to the payment rates dentists in Medicaid, and the availability and use of dental services by children. They also reviewed the reports of the testifying experts for both sides and prepared questions to ask the opposing expert, a dentist, at trial.
Analyses of nurses compensation for antitrust allegations
ERS Group was retained by multiple hospital systems across the country to analyze nurses’ wage data in response to class action allegations of collusion between the hospitals in setting wage levels. ERS Group’s experts collected data on actual nurse work histories, qualifications, shifts worked, shifts applied to, payroll data, and numerous policy documents. Our experts constructed analytical files that from extremely large data files, and created an economic model that accounted for actual employment practices and policies at the various hospitals. Our analyses quantified the extent by which the compensation structures were different among nurses, thereby supporting the defendants’ belief that the purported class was too broadly-defined.
Audit of insurance premium revenue for health & life insurance company
ERS Group was retained by a national provider of health and life insurance to review the data collected and the processes used to calculate premium revenue and to report taxable revenue to individual states.
Estimate of the impact of implementation of new tax law
ERS Group economists were engaged by the department of revenue for a southern state to provide revenue estimates and forecasts of the revenue effect of proposed changes to current tax laws. Our experts prepared tax models, calculators and table generators for use by state personnel to estimate expected revenues.
Sales tax gap analysis provided to mid-west and northeastern states
ERS Group experts were engaged by the department of revenue for a mid-west state and the office of general counsel for a northeast state to provide a sales and use tax gap study utilized to forecast changes in proposed tax laws and the effect of collection of Sales and Use tax receipts.
Measurement of the economic impact of continued budget cuts on the judiciary
ERS Group experts were engaged to perform economic impact studies on the effects of budget cuts to the judiciary. The analysis reviewed the economic output losses, employment losses and the State and Local tax losses.
Business disparity study
ERS Group experts conducted a business disparity study for a major southeastern city, for which ERS Group included a survey of businesses to determine firm characteristics that were used to measure the capacity of the firms to be included in the business opportunity plan.
Statistical and economic analysis of operations for annual fiscal review
ERS Group’s economists were retained by the clerks of courts operations corporation of a Southern state to review data collected by each county office related to case load and budget, construct peer groups of offices, and then conduct statistical analyses of peers. ERS Group provided a report of its findings and recommendations to the corporation upon completion of the project.
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