Fraud in Healthcare Under Heightened Scrutiny

Effective Compliance Strategies in the Face of New DOJ/HHS Fraud Initiatives

Fraud Enforcement and Recovery Act expands FCA liability starting May 20

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


Conducted on Tuesday, July 14, 2009

Recorded event now available

or call 1-800-926-7926
Program Materials

The teleconference/webinar format offers two options for participation: audio only via telephone (download speaker handouts prior to the program) or audio via phone plus online viewing of speaker-controlled PowerPoint presentations.

This seminar will examine the Fraud Enforcement and Recovery Act of 2009 (FERA) and the significant changes it makes to the False Claims Act. The panel will discuss current enforcement trends and steps healthcare providers and counsel must take to ensure compliance.

Description

A new federal focus on false claims enforcement affects all healthcare providers. On May 20, 2009, the president signed the Fraud Enforcement and Recovery Act of 2009 (FERA), expanding liability for false claims to the federal government and increasing the likelihood of whistleblower reports.

On May 28, 2009, a major pharmaceutical maker agreed to pay $95.5 million to settle Department of Justice allegations that it violated the FCA by misreporting drug prices. The DOJ and the Department of Health and Human Services recently announced a new interagency team to combat healthcare fraud.

The heightened risk of investigation and liability, increased repayment obligations, and new retaliation exposures mean healthcare providers, health plans and their counsel must review and tighten their practices for dealing with Medicare and other federal programs.

Listen as our authoritative panel of healthcare law attorneys examines the impact of FERA and key changes to the False Claims Act, including current FCA enforcement trends. The panel will outline strategies for implementing and maintaining compliance programs for providers and their counsel.

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Outline

  1. Impact of FERA and key changes to the FCA
    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. Statute of limitations
    7. Implications for healthcare providers
  2. FCA enforcement trends
    1. Health Care Fraud Prevention and Enforcement Action Team (HEAT)
    2. Deficit Reduction Act impact
    3. State FCAs and Federal Medical Assistance Percentage (FMAP)
  3. 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:

  • How does the FERA amend the False Claims Act?
  • What are the key elements of an effective compliance strategy to avoid FCA violations?
  • What steps can healthcare providers take now to mitigate their exposure to whistleblower actions?

Faculty

T. Jeffrey Fitzgerald
T. Jeffrey Fitzgerald

Partner
Faegre & Benson

His practice focuses on fraud and abuse, Medicare reimbursement, compliance and other regulatory issues. He represents...  |  Read More

Jonathan Diesenhaus
Jonathan Diesenhaus

Partner
Hogan & Hartson

He focuses on healthcare fraud and abuse litigation and counseling, federal and state False Claims Act litigation, and...  |  Read More

Michael W. Paddock
Michael W. Paddock

Partner
Crowell & Moring

He focuses on healthcare fraud and abuse matters and advises clients on compliance matters, the conduct of internal...  |  Read More

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