About the Authors
Dedications

Chapter 1: The Fraud Enforcers: Who Are They and What Do They Do?
Chapter 2: Federal Anti-Kickback Laws
Chapter 3: Federal Physician Self-Referral Prohibitions
Chapter 4: False Claims: Civil and Criminal Enforcement
Chapter 5: Administrative Sanctions Available to Federal Enforcers
Chapter 6: State and Private Initiatives to Combat Fraud
Chapter 7: Compliance and Self-Reporting
Chapter 8: Fraud and Abuse Issues Affecting the Managed Care Industry
Chapter 9: Representing Healthcare Organizations in Fraud and Abuse Matters
Chapter 10: The Future: Fraud and Abuse

 

American Health Lawyers Association (AHLA)

Leading health law to excellence through education, information, and dialogue, the American Health Lawyers Association (AHLA) is the nation's largest, nonpartisan, 501(c)(3) educational organization devoted to legal issues in the healthcare field. AHLA provides a wide variety of resources to address the issues faced by law firms, government, in-house counsel and academia and those who represent the entire spectrum of the health industry.

David E. Matyas

David E. Matyas is a member of Epstein Becker & Green's Health Care and Life Sciences practice in the firm's Washington, D.C., office. Mr. Matyas represents and defends healthcare entities in connection with government audits and investigations; helps clients develop, implement and evaluate healthcare corporate compliance programs; counsels clients in planning and structuring transactions and business arrangements to minimize fraud and abuse and understand reimbursement implications in matters related to healthcare transactions; and advises clients on legal and regulatory matters in connection with investment documents, offering memoranda, filings with the SEC and other transactional documents. Mr. Matyas represents an array of healthcare providers including hospitals and health systems, pharmaceutical and medical device manufacturers, academic medical centers, retail and specialty pharmacies, ambulatory surgery centers, home health agencies, and physician organizations. He also advises investors and other financial institutions that invest in or support the healthcare industry. From 2005 to 2008, Mr. Matyas had been appointed by the Secretary of the Department of Health & Human Services to the Advisory Committee on Blood Safety & Availability, which provides advice on broad public health, ethical and legal issues related to the nation's supply of blood and blood products. From 2002 to 2008, Mr. Matyas served as a member of the Board of Directors for the American Health Lawyers Association. In 2005 and in 2010, Mr. Matyas was selected by the editors of Nightingale's Healthcare News as one of the "Outstanding Fraud & Compliance Lawyers." Mr. Matyas is also listed in the District of Columbia Healthcare category of Chambers USA, The Best Lawyers in America, and in Washington, D.C., Super Lawyers magazine.

Carrie Valiant

Carrie Valiant is a member in Epstein Becker & Green's Health Care and Life Sciences Practice in the Washington, D.C., office where she co-chairs the firm's healthcare fraud group. Ms. Valiant has 25 years of experience concentrating in healthcare fraud and abuse and government healthcare program payment matters, including: defending clients undergoing civil and criminal investigation for healthcare fraud by the Department of Justice, the Department of Health and Human Services Office of the Inspector General, and other state and federal governmental authorities, including the negotiation of corporate integrity agreements; representing all segments of the healthcare industry in managing government healthcare program compliance risks, including the design and implementation of corporate compliance programs, preparation of OIG advisory opinion requests, and conducting internal investigations and voluntary self-disclosures. Ms. Valiant also advises clients on a variety of government healthcare program payment and certification matters, including substantial overpayment assessments, EMTALA complaints, and privacy and security breaches, including the preparation and negotiation of Corrective Action Plans. Ms. Valiant writes and lectures extensively on health law fraud topics and has been included on Nightingale's Healthcare News' 2004 and 2009 lists of Outstanding Healthcare Fraud and Compliance Lawyers and in the health law section of The Best Lawyers in America,

Jason Eric Christ

Jason Eric Christ is an attorney in Epstein Becker & Green's Health Care and Life Sciences group who focuses his practice on representing clients in the healthcare industry in state and federal investigations and litigation pertaining to the healthcare fraud and abuse laws. Specifically he defends clients in civil and criminal matters involving various state and federal false claim laws, Stark Law, the Anti-kickback Statute, and the federal Health Care Fraud statute. On behalf of his clients, Mr. Christ responds to audits, subpoenas, Civil Investigative Demands and letter requests from fraud enforcement entities including government and government contractors and shepherds all phases of such investigations through final resolution. He also assists clients with complex electronic discovery involving electronic medical records and proprietary Health IT systems and counsel clients on document retention and data preservation practices. Additionally, Mr. Christ provides health regulatory counseling to a variety of entities including hospitals, urgent care centers, physician groups, pharmacies, manufacturers, suppliers, insurers, skilled nursing facilities, and medical professional staffing organizations. Mr. Christ received his law degree with honors from the University of Maryland School of Law. While in law school, he earned University of Maryland's concentration in healthcare law and served as managing editor of the Journal of Health Law & Policy. For his undergraduate degree, he attended the Pennsylvania State University and the American University in Cairo and received his B.A. with distinction. Mr. Christ writes, speaks and publishes on matters involving the healthcare fraud and abuse laws and electronic discovery and currently serves is a member of the adjunct faculty at the American University Washington College of Law's Health Law and Policy Institute. He is admitted to practice in the District of Columbia, Maryland and the U.S. District Court for the District of Columbia.

Anjali N.C. Downs

Anjali N.C. Downs is an attorney of Epstein Becker Green's Health Care and Life Sciences Practice in the firm's Washington, D.C., office. She practices in the firm's Health Care Fraud Practice Group, which focuses on federal and state fraud issues, including anti-kickback, self-referral, false claims, secondary payor issues, and false billings. Ms. Downs represents a variety of healthcare and life science organizations including health systems, pharmaceutical and medical device manufacturers, pharmacies, clinical laboratories, academic medical centers, physician group practices, dialysis providers, and medical transportation providers. Ms. Downs' experiences include conducting internal health regulatory investigations; assisting clients in preparing self disclosures; representing and defending healthcare entities undergoing government investigations, inquiries and audits; assisting clients in developing, implementing, and evaluating corporate compliance programs; and advising clients on physician contracting arrangements and a variety of healthcare joint ventures. Ms. Downs received her law degree, cum laude, from the Francis King Carey School of Law at the University of Maryland, and her Masters of Public Health in Community Heath Education and undergraduate degree in Psychology from the University of Maryland. While attending law school, Ms. Downs served as an Articles Editor for the Journal of Health Care Law and Policy. She is admitted to practice law in Maryland and the District of Columbia. Prior to law school, Ms. Downs was a member of the adjunct faculties of Georgetown University School of Nursing and Health Studies and Howard Community College in Columbia, Maryland.