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Health Care Fraud: Enforcement and Compliance
Incisive Media, Pages: 1,200
Health Care Fraud: Enforcement and Compliance is the most complete, essential and up-to-date guide for criminal and civil lawyers, law enforcement officials, health care providers and anyone interested in the health care industry. You'll find: discussion of the latest antifraud initiatives from Congress, enforcement agencies and the private bar; advice on criminal law and procedures that health care lawyers cannot afford to ignore; and point-by-point analysis of key decisions, laws and regulations.
This deskbook also helps you decide on the right pretrial and trial strategies for clients who have already run afoul of the rules. It features cutting-edge discussions of such topics as: the use of health care fraud laws to enforce clinical care standards; voluntary and involuntary disclosure obligations; expanded treatment of the Federal Antikickback Statute—including “Safe Harbor” regulations—and the False Claims Act; proving billing fraud for rendering medically unnecessary services and other fraudulent schemes; obstruction of criminal investigations of health care offenses; and mandatory and permissive exclusion of professionals from health care programs.
Health Care Fraud: Enforcement and Compliance also includes detailed coverage of two important areas: compliance issues, including an analysis of Corporate Integrity Agreements, and marketing and pricing fraud in the pharmaceutical industry, including off-label, AWP, Medicaid rebate and kickback concerns.
Your purchase price includes the cost of all previous updates and any updates that may be issued within three months of your order.
About the Authors
Robert Fabrikant
Robert Fabrikant is a partner in the Washington, D.C. office of Sidley Austin LLP. Since 1982, Mr. Fabrikant has specialized in representing health care providers, suppliers and trade associations in white-collar criminal, civil and administrative litigation. His areas of concentration are fraud and abuse, False Claims Act, RICO and antitrust matters. Prior to entering private practice, Mr. Fabrikant was a trial attorney in the Antitrust Division, U.S. Department of Justice; an Assistant U.S. Attorney for the District of Columbia; a Faculty Member, University of Singapore Law School; Counsel, Monetary Authority of Singapore; and a law clerk to Judge Warren E. Burger, United States Court of Appeals for the District of Columbia Circuit, and later senior law clerk to Chief Justice Burger. He is a member of the New Jersey, District of Columbia and California Bars.
Paul E. Kalb, M.D.
Paul E. Kalb, M.D., is a partner in the law firm of Sidley Austin LLP and heads the firm's national Healthcare practice. He principally represents health care providers and pharmaceutical and medical device manufacturers in criminal, civil and administrative litigation and enforcement actions arising under the various health care fraud statutes. His practice includes both general and appellate (including Supreme Court) litigation. He is the author of numerous articles in both the legal and medical literature. He is Board-certified in Internal Medicine and a graduate of Yale Law School. He is a member of the District of Columbia State Bar and the American Bar Association.
Mark D. Hopson
Mark D. Hopson is a partner in the law firm of Sidley Austin LLP and practices in the firm's Washington, D.C. office. His practice involves complex civil and criminal trial litigation, as well as the conduct of internal investigations and compliance-related counseling. He has substantial experience in the representation of health care providers and consultants in connection with criminal and civil investigations and litigation, particularly with respect to claims under the False Claims Act. He is a member of the District of Columbia Bar.
Pamela H. Bucy
Pamela H. Bucy is the Bainbridge Professor of Law at the University of Alabama School of Law. Prior to entering teaching, she served as an Assistant United States Attorney, Criminal Division, E.D. Missouri. In this capacity, Professor Bucy prosecuted white collar crimes, including health care fraud. She also established and served as the first coordinator of a health care fraud task force comprised of attorneys and investigators from federal, state and private offices. Professor Bucy is a member of the American Bar Association and the Alabama and Missouri Bars. She has served on many ABA, state and local bar committees including service as Co-chair of the ABA subcommittee on Health Care Fraud.
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