Prosecuting and Defending Health Care Fraud Cases PDF Download
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Author: Michael K. Loucks Publisher: Bna Books ISBN: 9781570181733 Category : Law Languages : en Pages : 954
Book Description
Fraud & abuse issues faced by health providers & health care attorneys--whether prosecutor or defense counsel--are complex & wide-ranging. This book, written by two experienced litigators, identifies & analyzes these difficult medical, regulatory, & law enforcement issues. The book will assist prosecutors in conducting thorough & complete investigations--& guide transactional lawyers & defense counsel in anticipating & dealing with potential pitfalls. Beginning with a detailed overview of the law of health care fraud, the authors explain how the disconnected nature of treatment choices & payment mechanisms has increased the opportunity for abuse of the system & raised the stakes for all players. Drawing on their valuable experience, authors address the enforcement tools designed by Congress & the regulatory agencies to prevent & prosecute false billing & corruption. Chapters focus on federal criminal statutes, the civil False Claims Act, the Food & Drug Act, the Anti-Kickback Statute & Stark Prohibitions (and related safe harbors), & Department of Health & Human Services advisory opinions. The authors also explain the litigation & settlement process & the various outcomes.
Author: Michael K. Loucks Publisher: Bna Books ISBN: 9781570181733 Category : Law Languages : en Pages : 954
Book Description
Fraud & abuse issues faced by health providers & health care attorneys--whether prosecutor or defense counsel--are complex & wide-ranging. This book, written by two experienced litigators, identifies & analyzes these difficult medical, regulatory, & law enforcement issues. The book will assist prosecutors in conducting thorough & complete investigations--& guide transactional lawyers & defense counsel in anticipating & dealing with potential pitfalls. Beginning with a detailed overview of the law of health care fraud, the authors explain how the disconnected nature of treatment choices & payment mechanisms has increased the opportunity for abuse of the system & raised the stakes for all players. Drawing on their valuable experience, authors address the enforcement tools designed by Congress & the regulatory agencies to prevent & prosecute false billing & corruption. Chapters focus on federal criminal statutes, the civil False Claims Act, the Food & Drug Act, the Anti-Kickback Statute & Stark Prohibitions (and related safe harbors), & Department of Health & Human Services advisory opinions. The authors also explain the litigation & settlement process & the various outcomes.
Author: Kevin J. Darken Publisher: ISBN: 9780834211711 Category : Actions and defenses Languages : en Pages : 0
Book Description
It is evident that the federal government is serious about cracking down on health care fraud. This book details how to prevent and defend criminal, civil, and administrative health care fraud investigations. All the key statutes, regulations and cases impacting the field are thoroughly analyzed from the author's unique perspective as both a former federal prosecutor and current white collar criminal defense attorney. This is a reference tool for a primary audience consisting of white collar criminal defense attorneys; attorneys specializing in health care law, particularly Medicare reimbursement, fraud and abuse, or compliance issues; in-house counsel for large to midsize health care corporations (e.g., hospital chains, teaching hospitals, HMOs, DME companies, billing firms, labs); and prosecutors and criminal investigators who want to know what issues defense counsel may raise.
Author: Linda A. Baumann Publisher: Bna Books ISBN: 9781570186622 Category : Law Languages : en Pages : 913
Book Description
Baumann (of Arent Fox LLP in Washington, DC) presents a general information reference resource for attorneys working in the field of health law that has been revised so as to be current through May 2007, although some material has been updated past that date in order to cover significant new developments, such as the new Stark III regulations issued in September 2007. Following the introduction, nine chapters address federal physician self-referral restrictions; application of the substantive, qui tam, and voluntary disclosure provisions of the False Claims Act in health care prosecutions; practical considerations for defending health care fraud and abuse cases; legal issues surrounding hospital and physician relationships; risk areas in managed care fraud and abuse for government program participants; corporate compliance programs; potential liabilities for directors and officers of health care organizations; disclosure of qui tam suits and investigations; and control of fraud, waste, and abuse in the Medicare Part D Program.
Author: Robert Fabrikant Publisher: Law Journal Press ISBN: 9781588520739 Category : Law Languages : en Pages : 1308
Book Description
Health Care Fraud: Enforcement and Compliance focuses on fraud and abuse issues involving health care providers as well as application of the laws governing fraud and abuse to manufacturers of drugs and medical devices and other non-providers such as medical researchers.
Author: Charles E. Piper Publisher: Taylor & Francis ISBN: 1040081797 Category : Law Languages : en Pages : 172
Book Description
Some have estimated that healthcare fraud in the United States results in losses of approximately $80 billion a year. Although there are many books available that describe how to detect healthcare fraud, few address what must be done after the fraud is detected. Filling this need, Charles Piper‘s Healthcare Fraud Investigation Guidebook details not only how to detect healthcare fraud, but also how to investigate and prove the wrongdoing to increase the likelihood of successful prosecution in court.The book starts by covering the history of healthcare insurance and the various types of fraud schemes. It presents Charles Piper‘s unique approach to investigating (The Piper Method) which allows readers to conduct as many as 10 simultaneous investigations for each case. It emphasizes the importance of simultaneously searching for waste and abuse as well as systemic weaknesses and deficiencies that caused or contributed to the problem or wrongdoing under investigation and then make recommendations for improvement. It also provides:Questions to ask whistleblowers, complainants, employers, employees, and healthcare providers who are suspectsTips on investigative case planning, goals, and strategiesSample visual aids for use when briefing others about your investigative findingsGuidance on presenting information obtained from healthcare investigations and on how to testify in courtTechniques for uncovering previously undetected fraudThe book includes a sample case study that walks readers through a mock case from the time the case is received through the end. The case study demonstrates how to initiate, plan, and conduct a thorough and complete healthcare fraud investigation while incorporating Piper‘s proven methodology.Sharing insights gained through Charles Piper‘s decades o