This boot camp will provide an in-depth understanding of the Federal False Claims Act, Federal Anti-Kickback Statute and Stark II, and discuss how a violation of the Anti-Kickback and/or Stark can be the basis for a whistle-blower action under the False Claims Act. 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.
WHY SHOULD YOU ATTEND
This session is designed for health care executives, physicians and other health care providers who participate in and receive remuneration from Medicare, Medicaid, and other federal health care programs such as TriCare. As a health care executive, physician or other health care provider, you should be very concerned about the potential for enforcement actions under the Federal False Claims Act. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced.
Since 1986, whistleblowers have been awarded nearly $4 billion, with $439 million in awards in fiscal year 2012. And whistleblowers are where a majority of the Federal False Claims Act suits originate. Several recent cases involving healthcare providers have resulted in huge settlements. If that is not enough to get your attention, consider the recent cases finding that the “responsible corporate officer doctrine” allows the government to hold hospital CEOs, Board Chairmen and others directly responsible for the fraud.
As a health care executive, physician or other health care provider, you should be very concerned about the potential for the government to use the Anti-Kickback Statute as one of the prime methods for enforcing the FCA, the primary enforcement tool used by the Justice Department. It is also concerning that, along with Stark II (the federal physician anti-referral law), the Anti-Kickback Statute can be and is being used as the basis for an action brought under the FCA. In this webinar, you will learn about the elements of the Anti-Kickback Statute, along with a general discussion of the various exceptions and safe harbors that you can rely on for protection against enforcement under these laws. This is important because under recently enacted health care laws, enforcement and health care fraud task forces have been greatly enhanced. In addition, the Affordable Care Act (better known as Obamacare), the government has greatly enhanced enforcement resources.
Three cases, The Christ Hospital case in Cincinnati, with a settlement in excess of $100 million, Tuomey Healthcare, with a verdict of 237.5 million, which was settled for $72.4 million, and the Hardeman Memorial Hospital case in Texas, with a settlement of $398, 230.56 stand out. In the Hardeman case, the Texas federal court sentenced former CEO Angela Edwards to 2 ½ years in prison and ordered her to pay $370,657 in restitution.
You will want to attend this boot camp to learn how to protect yourself and your organization.
• Federal False Claims Act (what it is and how it works),
• 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, and
• Recommendations to mitigate violations of the AKS.
We will provide an assessment of enforcement activities, showing how participants may be at risk. In addition, the boot camp will review recent cases and show how they potentially impact participants.
WHO WILL BENEFIT
• Hospital executives, particularly CEOs, COOs, CFOs, CNOs, and CMOs
• Nursing home executives
• Physician practice managers
• Other healthcare provider executives
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