FCA Medicare providers

Research Limitations

The limitations of this study include the following aspects. First, regarding external validity, this type of study is typically prone to the threat of selection bias. Traditionally, methodologists might suggest that such selection bias in this type of study could surface either from settlement or publication reasons (Hammer & Sage, 2002, pp. 562-563). In terms of any potential for selection bias regarding cases that settle, this study and its research questions do not address other aspects of FCA litigation that occur outside of the courts—such as the pressure to settle or the possibility of exclusion from the Medicare program.

The dataset used in this study does not include cases that settled before any opinion was written and issued about them. As was discussed in Chapter 1, there are no published estimates of the number of filed cases which settle, and certainly no reliable means of predicting all of the characteristics of settled cases. To speculate how an analysis of settled cases might compare to this study’s results would serve as mere conjecture.

While it would be ideal to know how settled cases might compare to cases that don’t settle, it is impossible to reliably predict this. Furthermore, aspects of this study could not be answered with settlement data, if any such reliable data actually existed. For instance, the entire fourth sub-question was designed to assess the courts’ written opinions to identify agency theory themes. After a case settles, there would be no court opinions to assess. Conjecture about the characteristics of settled FCA cases would not serve the reader and also would not be able to answer the research questions of this study.