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!




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.




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.




Dietary Supplements


Book Description




Crisis of Conscience


Book Description

We are living in a time of mind-boggling corruption, but we are also living in a golden age of whistleblowing. Over the past two decades, whistleblowers have emerged as both the government's best weapon against corporate misconduct and the citizenry's best defence against government. Drawing on relentless original research, including in-depth interviews with more than 200 whistleblowers, Crisis of Conscience is a modern-day David-and-Goliath saga, told through a series of riveting cases drawn from Big Pharma, the military, and beyond.




The Medical-Legal Aspects of Acute Care Medicine


Book Description

The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a comprehensive resource intended to provide a state-of-the-art overview of complex ethical, regulatory, and legal issues of importance to clinical healthcare professionals in the area of acute care medicine; including, for example, physicians, advanced practice providers, nurses, pharmacists, social workers, and care managers. In addition, this book also covers key legal and regulatory issues relevant to non-clinicians, such as hospital and practice administrators; department heads, educators, and risk managers. This text reviews traditional and emerging areas of ethical and legal controversies in healthcare such as resuscitation; mass-casualty event response and triage; patient autonomy and shared decision-making; medical research and teaching; ethical and legal issues in the care of the mental health patient; and, medical record documentation and confidentiality. Furthermore, this volume includes chapters dedicated to critically important topics, such as team leadership, the team model of clinical care, drug and device regulation, professional negligence, clinical education, the law of corporations, tele-medicine and e-health, medical errors and the culture of safety, regulatory compliance, the regulation of clinical laboratories, the law of insurance, and a practical overview of claims management and billing. Authored by experts in the field, The Medical-Legal Aspects of Acute Care Medicine: A Resource for Clinicians, Administrators, and Risk Managers is a valuable resource for all clinical and non-clinical healthcare professionals.




Crossing the Global Quality Chasm


Book Description

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.




Corruption, Crime and Compliance


Book Description

Michael Volkov's career has spanned 30 years as an attorney in Washington, D.C. - as a federal prosecutor, a Chief Counsel on the Senate and House Judiciary Committees, a trial attorney in the Antitrust Division and in private practice. This book will help anyone better understand anti-bribery compliance in the U.S. and beyond. "Michael Volkov's book is a compilation of articles on a number of subjects important to lawyers advising clients how to stay out of trouble. He is a prolific writer and I can say without question, we have not heard the last of his musings. Simply put, his book contains important information that should prove helpful to lawyers, particularly to those who practice in the white collar field." - Judge Stanley Sporkin, Former Director of the Division of Enforcement, U.S. Securities and Exchange Commission.




Section 1557 of the Affordable Care Act


Book Description

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.




False Premise, False Promise


Book Description

American health care is at a crossroads. Health spending reached $3.5 trillion in 2017. Yet more than 27 million people remain uninsured. And it's unclear if all that spending is buying higher-quality care. Patients, doctors, insurers, and the government acknowledge that the healthcare status quo is unsustainable. America's last attempt at health reform -- Obamacare -- didn't work. Nearly a decade after its passage in 2010, Democrats are calling for a government takeover of the nation's healthcare system -- Medicare for All. The idea's supporters assert that health care is a right. They promise generous, universal, high-quality care to all Americans, with no referrals, copays, deductibles, or coinsurance. With a sales pitch like that, it's no wonder that seven in ten people now support Medicare for All. Doctors, especially young ones, are coming around to the idea of single-payer, too. Democrats, led by the progressive wing of the party, hope to capitalize on this enthusiasm. In 2017, they introduced companion legislation in the House and Senate that would establish Medicare for All. They have already promised to do the same when the next Congress convenes in 2019. More than 70 House Democrats have joined a new Medicare for All Caucus. Senator Bernie Sanders is effectively already on the presidential campaign trail, making his case for single-payer. If Democrats take the White House and Senate in 2020, and hold onto the House, a Medicare for All bill could be among the first pieces of legislation presented to the new president for a signature. In this book, Sally C. Pipes, a Canadian native, will make the case against Medicare for All. She'll explain why health care is not a right -- and how progressives pressing for single-payer are making a litany of promises they can't possibly keep. Evidence from government-run systems in Canada, the United Kingdom, and other developed countries proves that single-payer forces patients to withstand long waits for poor care at high cost. First, she'll unpack the Medicare for All plans under consideration in Congress. She'll explain how radical they truly are. Medicare for All will not save $5 trillion, as some of its proponents claim. It will cost about $32 trillion over 10 years, according to analyses from the Urban Institute and the Mercatus Center. It will outlaw private health insurance. It will raise taxes by trillions of dollars. It will cut pay for doctors to the rates paid by Medicare and thereby exacerbate our nation's shortage of physicians. And it will ration care. Then, Sally will detail the horrors of single-payer. She'll start in Canada, whose single-payer system most closely resembles the one progressives have in mind for the United States. Analyses of the government-run systems in the United Kingdom and a few other developed countries will follow, with particular focus on the problems that these systems pose for patients and doctors. To substantiate her indictment of single-payer, Sally will marshal both quantitative and qualitative evidence. She'll highlight how Americans fare better than their peers in Canada and the United Kingdom on the health outcomes that are directly linked to the quality of a healthcare system, including survival rates for patients with cancer and cardiovascular issues. She'll also explain why the health outcomes where the United States performs poorly relative to other nations, like infant mortality and life expectancy, tell us little about our healthcare system. Sally will pepper her text with heart-wrenching stories of the human costs of single-payer -- of people who were injured, were forced to remain in pain, or even died because their government-run healthcare system delayed or denied care. Too often, evangelists for free markets limit their arguments to facts and statistics -- and fail to appeal to the public's emotions. Sally will feature the stories of individuals and families who have been victims of single-payer systems. These vignettes will help drive home the truth about single-payer -- and why it must not come to the United States. She'll conclude with her vision for delivering the affordable, accessible, quality care the American people are looking for.