Healthcare Fraud and Abuse in a Tougher Enforcement Environment

Lessons Learned From Recent DOJ/HHS Fraud Investigations, Prosecutions and Settlements

Recording of a 90-minute CLE webinar/teleconference with Q&A

Conducted on Thursday, April 8, 2010
Recorded event now available

This CLE webinar will prepare healthcare counsel to implement and maintain effective fraud compliance and prevention programs. The panel will review the latest developments related to healthcare fraud, drawing lessons from recent government investigations and settlements.

Description

2009 was a record year for recoveries due to fraud and abuse in the healthcare industry. Recent government settlements included $100 million from one hospital and $2.3 billion from a major pharmaceutical. Clearly, healthcare fraud is a top priority for federal government enforcement.

Moreover, key changes to False Claims Act (FCA) in the Fraud Enforcement and Recovery Act of 2009 (FERA) expanded liability of healthcare providers and significantly extended the Department of Justice’s investigational authority.

As federal and state authorities continue to vigorously pursue and prosecute healthcare fraud and abuse, healthcare providers and counsel must scrutinize internal compliance programs to minimize and mitigate risks of FCA violations and whistleblowers actions.

Listen as our authoritative panel of healthcare attorneys examines the impact on the healthcare industry of recent FCA changes and the passage of FERA, discusses current government enforcement trends, and offers strategies for implementing and maintaining compliance programs.

Outline

  1. Impact of FERA and FCA amendments
    1. Fraud against government contractors and grantees
    2. Conspiracy
    3. Retention of overpayments
    4. Expanded whistleblower protections
    5. Expanded investigative tools for Dept. of Justice
    6. Implications for healthcare providers
  2. Fraud enforcement trends
    1. Investigations
    2. Settlements
    3. Whistleblower litigation
  3. Potential impact of proposed legislative changes to federal fraud and abuse laws
    1. False Claims Act
    2. Anti-Kickback statute
    3. Sentencing and penalties
    4. Other
  4. Strategies for implementing and maintaining compliance programs
    1. Designing a program — policies and procedures for detecting and preventing fraud, waste and abuse
    2. Implementing a program
    3. Training
    4. Monitoring
    5. Response to violations

Benefits

The panel will review these and other key questions:

  • What lessons can be learned from recent enforcement actions and settlements?
  • What steps can healthcare providers take now to mitigate their exposure to whistleblower actions?
  • What are the key elements of an effective compliance strategy to avoid FCA violations?

Faculty

Michael W. Paddock, Partner
Crowell & Moring, Washington, D.C.

He focuses on healthcare fraud and abuse matters and advises clients on compliance matters, the conduct of internal investigations related to potential fraud and abuse issues, and responding to and defending against government anti-fraud and abuse enforcement efforts and regulatory inquiries, including qui tam and government allegations of False Claims Act violations.

Robert C. Threlkeld, Partner
Morris Manning & Martin, Atlanta

He has substantial experience in Medicare and Medicaid fraud and abuse matters, managed care disputes, false claims and whistleblower cases, certificate of need matters, licensure and medical staff disputes. He represents hospital systems, physician practice groups and other healthcare providers in a range of regulatory matters, and regulatory and business disputes.

Michael A. Dowell, Partner
Hinshaw & Culbertson, Los Angeles

He counsels on structuring contracts, joint ventures, and other business arrangements to comply with the anti-kickback and Stark fraud and abuse laws, corporate practice of medicine and fee-splitting prohibitions, as well as other regulatory requirements. He defends also clients subject to state or federal anti-kickback, false claims, or whistleblower allegations.

Ordering

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Customer Reviews

The interactive questions at the end added value to the educational topic discussed during the presentation.

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Heninger & Heninger

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Staten Island University Hospital

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Health Law Advisory Board

Lowell C. Brown

Partner

Arent Fox

Ryan S. Johnson

Shareholder

Fredrikson & Byron

Gina M. Kastel

Partner

Faegre Baker Daniels

Karen S. Lovitch

Member

Mintz, Levin, Cohn, Ferris, Glovsky and Popeo

David A. Manko

Partner

Rivkin Radler

John J. Miles

Principal

Ober Kaler

J. Peter Rich

Partner

McDermott Will & Emery

Donald H. Romano

Of Counsel

Foley & Lardner

Judith A. Waltz

Partner

Foley & Lardner

John R. Washlick

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Buchanan Ingersoll & Rooney

Jesse A. Witten

Partner

Drinker Biddle & Reath

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