Description
Learn to properly recognize fraud and gain an understanding of enforcement trends in the health care industry.Legal developments in enforcement in the health sector have been fast and furious over the past 12 months. Not only are federal and state law enforcement and regulatory authorities actively focusing on individuals and companies operating in the health care sector, they are increasingly relying on aggressive legal theories in their cases. From diverging interpretations of the Escobar materiality holding to novel application of the Travel Act, it is hard for practitioners to keep up in this fastpaced legal and enforcement environment.This topic, which is being led by two veteran health care enforcement defense attorneys, will summarize the most important developments in health care enforcement, both criminal and civil, over the past year and provide predictions for the future. Topics covered include hot cases brought by federal authorities, new federal charging theories and trends including EMR certification and managed care plan cases, health care investorVC liability, trends in state attorney general enforcement, postEscobar discovery and materiality rulings in federal court, the latest word in cooperation credit, the impact of the Granston Memo, and strategizing in a parallel investigation in light of the evolving enforcement landscape.
Date: 2020-05-05 Start Time: End Time:
Learning Objectives
Latest Enforcement Trends
• Key Government Enforcement Cases Over the Past 12 Months
• Areas of Focus
• PAPs
• EMR Certification Compliance
• Medicare Plans
• Kickback Trends
• Opioid
• Genetic Testing
• Use of the Travel Act and Other Statutes to Charge Kickbacks in Private Pay Context
• Largest Settlements
• Geographic Disparity in Charging Decisions
• Increase in State Enforcement
Convincing DOJ to Dismiss the FCA Case
• DOJ’s New Willingness to Dismiss Cases
• Has It Made a Difference?
• How to Convince DOJ to Dismiss Your Client’s FCA Case
Continued Importance of Materiality Issues
• Materiality in Criminal Cases
• Recent Acquittals and What They Tell Us
• Jury Instructions
• Discussion on How to Approach Materiality in Typical Health Care Fraud Criminal Matter
• Materiality in Civil False Claims Act Cases
• Escobar and Its Progeny
• Impact on Motion Practice
• Impact on Discovery Practice
Predicting the Future
• What’s Ahead for Criminal Enforcement?
• What’s Ahead for Civil Enforcement?
What Legal Counsel Should Focus on Now
• Focusing on Materiality
• The Self-Reporting Trick Bag
• Cooperation in Light of the Granston Memo
• Educating the Regulators
What Compliance Professionals Should Focus on
• Examine EMR Certification and HITECH Compliance
• Auditing Compliance With Existing AKS Restrictions
• Assessing Exposure to Private Pay Kickback Allegations
ACFE ,CLE (Please check the Detailed Credit Information page for states that have already been approved) ,Additional credit may be available upon request. Contact Lorman at 866-352-9540 for further information.
Carolyn McNiven-Greenberg Traurig, LLP, Jessica Natali – Greenberg Traurig LLP
