Stemming back to 1863, the False Claims Act, which is often referred the “Lincoln Law”, remains the federal government’s number one fraud fighting tool for returning monies to the federal fisc. The 1986 Amendments, as well as the various amendments under the Fraud Enforcement and Reduction Act (FERA) and the Affordable Care Act (ACA), have given the government and relators’ counsel additional tools and avenues to pursue in relation to False Claims Act cases.

Combatting healthcare fraud has been and remains a top priority for the U.S. Department of Justice – Civil Frauds Division, as well as the Department of Health and Human Services’ (HHS) Health Care Fraud Prevention and Enforcement Task Force (HEAT) and HHS Office of the Inspector General. Common areas of enforcement include Anti-Kickback Statute (AKS), Stark Law, factually false claims where no goods or services were provided but claims were submitted to government programs for payment. Additionally, new areas of interest include cybersecurity, COVID-19 fraud, and Controlled Substance Act violations. In 2023, two opinions were issued by the United States Supreme Court addressing two areas of the False Claims Act.

Fortunately, compliance departments and defense counsel have a roadmap for mitigating liability in certain circumstances – both for corporate entities and for individuals. The purpose of this webinar is to provide an overview of what constitutes a false and fraudulent claim, what scienter is required, and recent cases from the hot areas in healthcare, as well risk mitigation strategies.

Learning Objectives:

• Understand the nuances of the False Claims Act
• Appreciate the key areas of enforcement
• Learn about the key take-aways from recent Supreme Court cases
• Mitigate risk through the OIG’s Guidance
• Recognize potential false and fraudulent claims before submission
• Be cognizant of the “knowledge” requirement in the False Claims Act

Areas Covered in the Session:

• False Claims Act
• Fraud, waste and abuse
• AKS
• Stark Law
• Knowledge requirements for false and fraudulent claims
• Recent cases
• OIG and DOJ Compliance items
• Risk mitigation
• Live Q&A session

Suggested Attendees:

• Hospital Executives – CEOs, COOs, CFOs, CNOs, and CMOs
• Other Healthcare Provider Executives
• Healthcare provider Board Members
• Attorneys representing health care providers and practitioners
• Chief compliance officers
• Government Organizations
• Defense Counsel
• Relator’s Counsel
• Compliance Officers
• Billers and Coders
• Cybersecurity Professionals & Consultants
• Anyone in Healthcare