Fraud and Abuse 2016: Game-Changing Trends and Cases (and How to Protect Your Organization)

In 2014 the Department of Justice recovered $2.3 billion from healthcare fraud cases, marking the fifth straight year the Department recovered more than $2 billion from cases involving false claims against federal healthcare programs, such as Medicare, Medicaid, and TRICARE. From January 2009 through the end of the 2014 fiscal year, the Department used the False Claims Act (FCA) to recover $14.5 billion in federal healthcare dollars. And these amounts reflect federal dollars only. In many of these cases the DOJ was instrumental in recovering additional billions of dollars for consumers and states.

Clearly, every segment of the healthcare industry is enduring greater levels of scrutiny. While the focus has historically been on pharmaceutical and medical device manufacturers, surgeons, insurers, and long-term care facilities, other segments now are finding themselves in the crosshairs. For example, cases involving hospitals resulted in $333 million in settlements and judgments in 2014.

In a new webinar for Bloomberg BNA, Manatt examines the growing use of FCA as an enforcement tool and other enforcement trends, including the use of increasingly aggressive techniques such as video surveillance and wiretaps, making the healthcare landscape more perilous than ever in history. The session will explore key FCA provisions and explain how the Affordable Care Act (ACA) introduced both heightened penalties for healthcare organizations and additional incentives for whistleblowers. It also will take a close-up look at the major FCA cases that are remapping the fraud and abuse landscape and the decisions to watch for in 2016.

The webinar then will guide participants in building effective compliance programs that protect their organizations in today's stringent and complex enforcement environment. Attendees will learn both how to avoid FCA actions and what to do if the government does come calling. The session will share concrete steps for protecting their organizations, as well as for responding effectively if they do face a government inquiry.

Educational Objectives:

  • Track the growth in FCA recoveries and what's anticipated in months to come.
  • Look at the new healthcare stakeholders facing FCA cases and the types of violations being investigated for each segment.
  • Gain an understanding of FCA definitions, provisions, and penalties.
  • Explore key FCA cases and their impact.
  • Examine the latest enforcement trends, including the use of predictive modeling, videotaping, wire and securities fraud, and more.
  • Learn the enhanced provisions that are increasingly common in Corporate Integrity Agreements (CIA).
  • Discover how the ACA raised the stakes.
  • Hear the new rules and incentives around whistleblowers.
  • Find out how to build compliance programs that protect your organization.
  • Gain guidance on how to respond effectively if a government investigation happens.

The webinar will be led by Jacqueline Wolff, litigation partner and co-chair of Manatt's Corporate Investigations and White Collar Defense practice group, and Robert Hussar, counsel of Manatt's Healthcare division.

The program will be held on Tuesday, November 10, from 1 p.m. to 3:30 p.m. ET. Click here to register free, and earn CLE.

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