AHLA False Claims Act & The Health Care Industry


Book Description

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.







Litigation Services Handbook


Book Description

Here’s all the information you need to provide your clients with superior litigation support services. Get up to speed quickly, with the aid of top experts, on trial preparation and testimony presentation, deposition, direct examination, and cross-examination. Authoritative and highly practical, this is THE essential guide for any financial expert wanting to prosper in this lucrative new area, the lawyers who hire them, and litigants who benefit from their efforts. "This work of amazing breadth and depth covers the central issues that arise in financial expert testimony. It is an essential reference for counsel and practitioners in the field."—Joseph A. Grundfest, The William A. Franke Professor of Law and Business, Stanford Law School; former commissioner, United States Securities and Exchange Commission.







Federal False Claims Act and Qui Tam Litigation


Book Description

This book covers the merits of a potential action; determining whether the relator would be barred or restricted from any recovery for retaliation and more.




Health Care Fraud and Abuse


Book Description

Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.




Whistleblower's Handbook


Book Description

UPDATED IN MARCH 2013 to include the historic $104-million Bradley Birkenfeld whistleblower case and more! From the nation’s leading whistleblower attorney, comes the third edition of the first-ever consumer guide to whistleblowing. In The Whistleblower’s Handbook, Stephen Martin Kohn explains nearly all federal and state laws regarding whistleblowing. In the step-by-step bulk of the book, he also presents twenty-one rules for whistleblowers.




Undercover


Book Description

When John Schilling, an unassuming midlevel accountant, joined Columbia Healthcare Corporation -- the nation's fastest growing and revolutionary network of public hospitals -- it seemed like the start of an exciting new career with great advancement and earnings potential. He never expected to become a catalyst for the series of "whistleblower" lawsuits that ripped through the healthcare industry in the late 1990s In Undercover, John Schilling tells the story of his harrowing journey from ordinary citizen and loyal employee to covert FBI informant and top witness for the Justice Department in the largest criminal healthcare fraud case in U.S. history. It began when he stumbled upon evidence-- a $3.5 million accounting "error"--of his company's routine practice of defrauding Medicare. When pressured to comply with stealing from taxpayers, Schilling knew he had to speak up for what he believed was right, regardless of the cost to his job, his reputation, and his family. His courageous choice would consume the next seven years of his life, leading to more drama, angst, turmoil, and money than he could have imagined. Ultimately, Schilling's moral conviction and a little known law, the False Claims Act, paid off by forcing the formidable healthcare conglomerate of Columbia/HCA to pay back $1.7 billion to the federal government. Revealing the personal side of a thankless role, Undercover is a gripping and inspiring account of a long, hard, life-- changing quest for justice. ADVANCE PRAISE FOR UNDERCOVER "Undercover crackles with authenticity as it recounts in a lively, readable style how a man on the inside risked everything and blew the whistle on a giant healthcare company that was systematically looting the Medicare program out of billions. A good read for anyone, but a must-read for someone who may contemplate taking the same path as John Schilling" -- John R. Phillips, "The nation's premier whistleblowing attorney" according to the The Wall Street Journal and the National Law Journal "John Schilling's book is a must-read for whistleblowers. He shows you how hard it can be, yet also shows you how to prevail. Best of all, John shows you how to be a good citizen" -- Jim Moorman, past President, Taxpayers Against Fraud




Civil False Claims and Qui Tam Actions


Book Description

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!