Recent cases and/or enforcement actions involving the Federal Civil False Claims Act (FCA) raise serious concerns regarding compliance issues with hospitals, physician practices, and other healthcare entities. Recoveries under the FCA are at an all-time high, and the percentage of actions involving healthcare organizations has been increasing at exponential rates. Add to that, a substantial number of enforcement actions involve the Medicare/Medicaid Fraud and Abuse Anti-Kickback Statute (AKS), a violation of which has been held to be the basis of an action under the FCA.

The session will provide an overview of the Federal Civil False Claims Act (FCA) and how it works. It will also provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the session will review recent cases and show how they potentially impact participants.

Our expert, William Mack Copeland, MS, JD, Ph.D., start with a review of the Federal False Claims Act and discuss how it works and how it is being used to fight health care fraud. He will discuss how the various health care fraud task forces use the Federal False Claims Act and its whistleblower provisions to identify and prosecute health care fraud. The webinar will take the Federal False Claims Act apart and show step by step how an action is filed, how the government responds, and how the courts interpret various elements of the Act. The proof, damages under the Act, and how the whistleblower is rewarded for bringing a successful case will be discussed.

The session will also provide an in-depth review of the AKS, focusing on what is prohibited under the Act and what the exceptions are.  We will also review the case law, particularly the early case law that sets the stage and basis for how the courts interpret the law. The changes made to both the False Claims Act and the Anti-Kickback Statute made by the Affordable Care Act will be discussed. Finally, the webinar will review various cases to show how easy it is to run afoul of the Statute, and how the courts view compliance with it.

Learning Objectives:-

• Overview of the Federal Civil False Claims Act (FCA) and how it works
• Overview of the Federal Anti-Kickback Statute and how violations can be mitigated
• Provide an assessment of enforcement activities with an emphasis on prevention and compliance
• Understand how hospital and healthcare entities may be at risk
• Preview recent cases and show how they potentially impact your organization

Areas Covered in the Session:-

• Federal False Claims Act
• How the FCA is being used as an enforcement tool by the federal enforcement authorities
• Federal Civil Anti-Kickback Statute
• Safe Harbors providing protection under the AKS
• Enforcement activities involving the AKS
• Recommendations to mitigate violations of the AKS
• Recent cases and best practices in the industry

Who Should Attend:-

• Hospital CEOs
• Chief Operation Officers
• Chief Financial Officers
• Chief Medical Officers
• Compliance Officers
• Nursing Home Executives
• Physicians
• Physician Practice Managers
• Other Healthcare Provider Executives