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False Claims Act & The Healthcare Industry: Counseling & Litigation, Second Edition with 2011 Cumulative Supplement (Non-Members)

American Health Lawyers Association; Robert S. Salcido, Esq.

Price:	$219.00
Publisher:	AHLA
Format:	Electronic book: epub
ISBN:	9780327175308 6/2013

Description

Table of Contents »

Preface

About the Author

Dedication and Acknowledgements

Chapter 1. False Claims Act History
§ 1:00 Congressional Goals in Passing and Amending the Statute
§ 1:01 The 1863 Act and Its Immediate Aftermath
§ 1:02 The 1943 Act
§ 1:03 Case Law Developments Before the 1986 Amendments
§ 1:04 The 1986 Legislative History

Chapter 2. Application of the False Claims Act Substantive Provisions
§ 2:00 Substantive Provisions of the False Claims Act: An Introduction
§ 2:01 The Meaning of "Person" Under the False Claims Act
§ 2:02 The Meaning of "Cause" to Present a False or Fraudulent Claim
§ 2:03 False or Fraudulent Under the FCA
§ 2:04 An FCA "Claim," "Record" or "Statement" and Presentment Under Subsections 3729(a)(1) and (a)(2)
§ 2:05 Knowledge Under the False Claims Act
§ 2:06 Materiality
§ 2:07 Conspiracy
§ 2:08 Reverse False Claims

Chapter 3. Qui Tam Provisions
§ 3:00 Qui Tam Provisions: An Introduction
§ 3:01 Responsibilities of Attorney General - §3730(a)
§ 3:02 Actions by Private Parties - §3730(b)
§ 3:03 Rights of the Parties in Qui Tam Actions - §3730(c)
§ 3:04 Award to Qui Tam Plaintiff - §3730(d)
§ 3:05 Section 3730(e) Jurisdictional Bar - §3730(e)
§ 3:06 Expenses and Fees for which the Government is Responsible
§ 3:07 Whistleblower Retaliation Provision - §3730(h)
§ 3:08 Discovery in Relator-Only Lawsuits
§ 3:09 Application of Fed.R.Civ.P. 9(b) to the False Claims Act

Chapter 4. Damages and Civil Penalties
§ 4:00 The Computation of Damages and Civil Penalties Under the FCA: An Introduction
§ 4:01 Pre-1986 Cases Regarding the Scope of Damages Under the FCA
§ 4:02 The 1986 Legislative Amendments
§ 4:03 FCA Damages: Principles and Proof
§ 4:04 Practice Areas Raising Damage Issues
§ 4:05 Civil Penalties
§ 4:06 Constitutional Limitations on Civil Penalties

Chapter 5. False Claims Act Procedure and Jurisdiction
§ 5:00 Introduction
§ 5:01 False Claims Procedure
§ 5:02 FCA Jurisdiction

Chapter 6. Civil Investigative Demands
§ 6:00 CIDs: An Introduction
§ 6:01 CIDs as Administrative Subpoena
§ 6:02 Compliance with the Terms of Section 3733
§ 6:03 Relevance and Undue Burden
§ 6:04 Bad Faith and Abuse of Process
§ 6:05 Responsing to the CID

Chapter 7. The Voluntary Disclosure Program
§ 7:00 Submitting a Voluntary Disclosure: An Introduction
§ 7:01 The Operation of the Inspector General's Voluntary Disclosure Program
§ 7:03 Settling the Matter

Table of Cases

Index

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 November 2011, the Department of Justice announced that since the FCA was substantially amended in 1986, it had recovered more than $30 billion under the FCA, and in 2011, it recovered $3 billion, of which $2.4 billion was from health-related FCA cases. 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 2012 Cumulative Supplement (For information on or to purchase this Supplement, click here.) This 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 FCA
• What 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 ACTIONS
• When 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 DAMAGES
• How 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 LIMITATIONS
• How do courts compute the FCA statute of limitations?
VOLUNTARY DISCLOSURES TO THE OIG
• Under 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 PROVISION
• What does a retaliated against "whistleblower" need to prove to obtain damages from the employer?