False Claims Act & the Healthcare Industry

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ISBN 13 : 9781663338433
Total Pages : 0 pages
Book Rating : 4.34/5 ( download)

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Book Synopsis False Claims Act & the Healthcare Industry by : Robert S. Salcido

Download or read book False Claims Act & the Healthcare Industry written by Robert S. Salcido and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Significant events have occurred regarding the government's enforcement and administration of the False Claims Act (FCA) in the last few years. The government has continued to negotiate major settlements against healthcare entities, and the courts have issued numerous decisions that impact the manner in which healthcare businesses are organized and operated. In 2012, the Department of Justice announced that $3 billion of the $5 billion recovered under the FCA was health-related. With these recent developments in FCA litigation and the rapidly developing case law, you will need the Second Edition of False Claims Act & the Healthcare Industry and the 2014 Cumulative SupplementThis authoritative treatise will keep you up-to-date on the latest FCA developments so that you can more effectively advise your client on how to assess their company's potential exposure to liability, evaluate the exposure of companies that they may acquire, and reform company practices to reduce the risk of potential FCA liability.EXPERT ANALYSIS: THE ELEMENTS THAT CREATE LIABILITY UNDER THE FCAWhat does it mean to "Present or Cause to Present" a false claim?How do courts determine whether a claim is "False or Fraudulent"?How does one "know" under the FCA, that a claim is "False"?When is a claim "Material" to the government's determination to pay?LEADING DEFENSES THAT RESULT IN THE DISMISSAL OF QUI TAM ACTIONSWhen are lawsuits barred under the FCA public disclosure bar?What must the whistleblower prove to show that she qualifies as an "original source"?Under what circumstances do courts dismiss actions for failure to state fraud with specificity under Fed.R.Civ.P.9(b)?Under what circumstances does a plaintiff fail to show that defendant submitted a "false" claim or statement under the FCA?Under what circumstances does a plaintiff fail to establish that the defendant "knew" that a claim wa false or fraudulent?FCA DAMAGESHow do courts compute FCA damages in Healthcare upcoding cases and in cases alleging a violation of the FCA because of a violation of the Anti-Kickback or Stark Law?What are the limits courts may impose on the government's or whistleblower's ability to recover FCA damages?FCA STATUTE OF LIMITATIONSHow do courts compute the FCA statute of limitations?VOLUNTARY DISCLOSURES TO THE OIGUnder what circumstances should a company consider submitting a voluntary disclosure?What is the process underlying the submission of a voluntary disclosure?What are the potential benefits and risks associated with submitting a voluntary disclosure?THE FCA WHISTLEBLOWER RETALIATION PROVISIONWhat does a retaliated against "whistleblower" need to prove to obtain damages from the employer?The eBook versions of this title feature links to Lexis Advance for further legal research options.

AHLA False Claims Act & The Health Care Industry

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ISBN 13 : 9780769884592
Total Pages : pages
Book Rating : 4.98/5 ( download)

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Book Synopsis AHLA False Claims Act & The Health Care Industry by : American Health Lawyers Association

Download or read book AHLA False Claims Act & The Health Care Industry written by American Health Lawyers Association and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This Third Edition of False Claims Act & the Health Care Industry has been prepared in response to False Claims Act (FCA) amendments, the surge of false claims litigation and recoveries, and the rapidly developing case law. It is intended to help health care lawyers, accountants, executives, and other professionals assess a company's potential exposure to false claims liability and reform company practices to reduce the risk of liability by providing a comprehensive analysis of the FCA and its interpretation. This new edition analyzes legislative changes to:The FCA's reverse false claims provision;The FCA's whistleblower retaliation provision; andThe FCA's public disclosure bar.In the wake of these changes, courts across the country, including the United States Supreme Court, have issued significant decisions that impact the operation of health care businesses. This book analyzes those decisions, addressing:Defenses that the defendant's claim is not "false;"Defenses that the defendant did not "know" that the claim or statement is "false;"Defenses that the defendant's knowingly false claims or statements are not "material" to the government's determination to pay;The status of actions where the relator's action repeats public information;And more.

False Claims Act & the Healthcare Industry

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Publisher :
ISBN 13 : 9780769884585
Total Pages : 1050 pages
Book Rating : 4.8X/5 ( download)

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Book Synopsis False Claims Act & the Healthcare Industry by : Robert S. Salcido

Download or read book False Claims Act & the Healthcare Industry written by Robert S. Salcido and published by . This book was released on 2018 with total page 1050 pages. Available in PDF, EPUB and Kindle. Book excerpt:

False Claims Act and the Healthcare Industry

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Author :
Publisher :
ISBN 13 :
Total Pages : 468 pages
Book Rating : 4.45/5 ( download)

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Book Synopsis False Claims Act and the Healthcare Industry by : Robert Salido

Download or read book False Claims Act and the Healthcare Industry written by Robert Salido and published by . This book was released on 1999 with total page 468 pages. Available in PDF, EPUB and Kindle. Book excerpt:

False Claims Act & the Healthcare Industry

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Publisher :
ISBN 13 : 9780769884578
Total Pages : 1050 pages
Book Rating : 4.71/5 ( download)

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Book Synopsis False Claims Act & the Healthcare Industry by : Robert S. Salcido

Download or read book False Claims Act & the Healthcare Industry written by Robert S. Salcido and published by . This book was released on 2018 with total page 1050 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Phantom Billing, Fake Prescriptions, and the High Cost of Medicine

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Publisher : Cornell University Press
ISBN 13 : 0801461286
Total Pages : 253 pages
Book Rating : 4.86/5 ( download)

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Book Synopsis Phantom Billing, Fake Prescriptions, and the High Cost of Medicine by : Terry L. Leap

Download or read book Phantom Billing, Fake Prescriptions, and the High Cost of Medicine written by Terry L. Leap and published by Cornell University Press. This book was released on 2011-04-15 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: U.S. health care is a $2.5 trillion system that accounts for more than 17 percent of the nation’s GDP. It is also highly susceptible to fraud. Estimates vary, but some observers believe that as much as 10 percent of all medical billing involves some type of fraud. In 2009, New York’s Medicaid fraud office recovered $283 million and obtained 148 criminal convictions. In July 2010, the U.S. Justice Department charged nearly 100 patients, doctors, and health care executives in five states of bilking the Medicare system out of more than $251 million through false claims for services that were medically unnecessary or never provided. These cases only hint at the scope of the problem. In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap takes on medical fraud and its economic, psychological, and social costs. Illustrated throughout with dozens of specific and often fascinating cases, this book covers a wide variety of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud, as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering). After assessing the effectiveness of the federal laws designed to fight health care fraud and abuse—the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws—Leap suggests a number of ways that health care providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control, thereby reducing the overall cost of medical care in America.

Healthcare and the False Claims Act 2016

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ISBN 13 : 9780998601809
Total Pages : 270 pages
Book Rating : 4.02/5 ( download)

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Book Synopsis Healthcare and the False Claims Act 2016 by : David B. Honig

Download or read book Healthcare and the False Claims Act 2016 written by David B. Honig and published by . This book was released on 2017 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Health Care Initiatives Under the False Claims Act that Impact Hospitals

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Publisher :
ISBN 13 :
Total Pages : 116 pages
Book Rating : 4.88/5 ( download)

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Book Synopsis Health Care Initiatives Under the False Claims Act that Impact Hospitals by : United States. Congress. House. Committee on the Judiciary. Subcommittee on Immigration and Claims

Download or read book Health Care Initiatives Under the False Claims Act that Impact Hospitals written by United States. Congress. House. Committee on the Judiciary. Subcommittee on Immigration and Claims and published by . This book was released on 2000 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Healthcare and the False Claims Act

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ISBN 13 : 9780998601816
Total Pages : 400 pages
Book Rating : 4.10/5 ( download)

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Book Synopsis Healthcare and the False Claims Act by : Patrick Garcia

Download or read book Healthcare and the False Claims Act written by Patrick Garcia and published by . This book was released on 2018-06 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare and the False Claims Act, 2016 Survey summarizes the important laws, regulations, pronouncements, and cases of the past year, to inform healthcare providers and healthcare attorneys on this crucial statute in the healthcare industry.

Civil False Claims and Qui Tam Actions

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Publisher : Aspen Publishers
ISBN 13 : 9780735594944
Total Pages : 1970 pages
Book Rating : 4.45/5 ( download)

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Book Synopsis Civil False Claims and Qui Tam Actions by : John T. Boese

Download or read book Civil False Claims and Qui Tam Actions written by John T. Boese and published by Aspen Publishers. This book was released on 2010-12 with total page 1970 pages. Available in PDF, EPUB and Kindle. Book excerpt: Civil False Claims and Qui Tam Actions is an essential weapon for bringing or defending a qui tam action. This Fourth Edition, two-volume treatise provides comprehensive analysis of The Civil False Claims Statute and a balanced approach to every important aspect of case preparation and litigation -- from establishing the merits of a whistleblower claim to determining the formula for arriving at the qui tam plaintiff's award. Civil False Claims and Qui Tam Actions, frequently cited by the courts, is clearly and concisely written to: walk you, step-by-step, through each phase of case preparation, from the perspective of both plaintiff-relator and whistleblower defendant spell out the unique procedural requirements in a civil false claims action -- from the applicability of statute of limitation rules to the scope of discovery under a andquot;civil investigation demandandquot; by the federal government explain how to draft a whistleblower complaint collect, organize and interpret the controlling case law direct you to the relevant statutory whistleblower provisions, rules and regulations that apply to the issues under discussion analyze the legislative history of The False Claims Act and explains why it is essential to the success of a prosecutor's or defense's cause of action and alert you to emerging trends in civil false claims and qui tam actions For the best guidance on how to bring or defend a qui tam action, consult the civil false claims specialist - John T. Boese. John T. Boese is an expert author and litigation partner in the Washington, DC law office of Fried, Frank, Harris, Shriver andamp; Jacobson. with more than 25 years of experience in civil fraud cases, both as a former DOJ attorney and as defense counsel. In a clear and straightforward manner, he offers his expert analysis of recent developments on: The Supreme Court's decision on andquot;original sourceandquot; in Rockwell The recent trend by state legislatures to enact false claims laws that mirror the federal law. The andquot;presentmentandquot; requirement Corporate liability under The Civil False Claims Act Interpreting the public disclosure bar and original source requirement Challenges to sufficiency of FCA complaints under Rule 9(b) The Civil False Claims Act has captured the attention of any organization doing business with the federal government, for very good reasons: Virtually any person that receives, spends or uses federal money may be liable under The Civil False Claims Act. Private individuals, including employees can be whistleblowers on contractor fraud by bringing a qui tam lawsuit on behalf of the federal government - and receive up to 30% of any judgment or settlement. The courts have upheld highly creative claims brought under The Civil False Claims Act. Don't get lost in the maze of changing, complicated, and confusing qui tam provisions, whistleblower rules, and civil false claims regulations!