Tell us about your biggest trial win from January 2016 to July 2017 and how you achieved the result for your client.
Aetna sued a group of ambulatory surgery centers (ASC) for billing fraud and a related conspiracy. Defendants overcharged Aetna $37.5 million by paying doctors kickbacks for referrals, quoting patients lower prices than they charged Aetna and telling patients who complained they would not be billed personally.
At trial, doctors testified about payments received, which we linked to referral patterns. We compared the ASC’s charges to lower charges from world-class hospitals. We proved the ASCs pressured doctors to refer high-priced procedures. And employers and patients testified about the harm caused.
After a monthlong trial, the jury found for Aetna and awarded $37.5 million. To settle, defendants sold a controlling interest to a legitimate operator and are paying Aetna $40 million, plus interest.
Share two trial tips that have been key to your success.
1) Build trial themes around right and wrong. Juries want to know who wears the black hat, who wears the white hat and how to make things right.
2) Cut to the chase when examining witnesses. The jury will stay focused and be grateful if they know everything you present matters. — Richard Doren