Healthcare Fraud and Abuse in a Tougher Enforcement Environment

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

Government recovers billions from healthcare industry in 2009

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

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Conducted on Thursday, April 8, 2010

Recorded event now available

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Course Materials

This CLE course 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.


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.



  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


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?


Michael W. Paddock
Michael W. Paddock

Crowell & Moring

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

Threlkeld, Robert
Robert C. Threlkeld

Morris Manning & Martin

Mr. Threlkeld has substantial experience in Medicare and Medicaid fraud and abuse matters, managed care disputes,...  |  Read More

Michael A. Dowell
Michael A. Dowell

Hinshaw & Culbertson

He counsels on structuring contracts, joint ventures, and other business arrangements to comply with the anti-kickback...  |  Read More

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