As Enforcement Tightens, How Can You Avoid FCA Actions?

In fiscal year (FY) 2016, the Department of Justice (DOJ) recovered $2.5 billion from healthcare fraud cases, marking the seventh consecutive year that healthcare civil fraud recoveries exceeded $2 billion. Between January 2009 and the end of FY 2016, the DOJ recovered $19.3 billion in healthcare fraud claims—and these figures represent just federal dollars. In many cases, the DOJ was instrumental in recovering additional millions of dollars for state Medicaid programs. And states continue to bring their own healthcare fraud cases.

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Between January 2009 and the end of FY 2016, the DOJ recovered $19.3 billion in healthcare fraud claims

In a new webinar for Bloomberg BNA, Manatt examines the growing use of the False Claims Act (FCA) as an enforcement tool and other enforcement trends—including increasingly aggressive techniques, from predictive modeling to wiretaps—making the healthcare landscape more perilous than ever before in history. Key topics include:

  • The types of FCA violations being investigated for each healthcare segment
  • Current trends in recoveries—and what’s next
  • The implications of the Escobar decision on implied false certification, materiality and FCA cases moving forward
  • Other major FCA cases that are remapping the fraud and abuse landscape—and the decisions to watch for in the year ahead
  • Innovative enforcement techniques that are changing the game 
  • The impact of recent DOJ cases on decisions relating to Medicare Advantage
  • The enhanced provisions that are increasingly common in Corporate Integrity Agreements (CIAs)
  • Strategies for protecting your organization, including how to build effective compliance programs and what to do if faced with a government investigation

Presenters
Jacqueline Wolff, Partner, Co-chair, Corporate Investigations and White Collar Defense and Co-chair, False Claims Act Practice
Richard Hartunian, Partner, Corporate Investigations and White Collar Defense
Randi Seigel, Counsel, Manatt Health