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Follow on Google News | The Knowledge Group Has Scheduled a Live Webcast on Emerging Issues in Health Care EnforcementEvent Synopsis: Increasingly, federal departments are addressing the frequent, persistent and growing complexity of healthcare fraud. The Department of Justice (DOJ) recovered over $2.3 billion in False Claims Act cases while the Federal Trade Commission (FTC) challenged several hospital and physician practice mergers and pursued anti-competitive pharmaceutical patent settlements. There is also a trend toward aggressive civil enforcement supplemented with new criminal prosecution methods, such as HEAT, previously confined to organized crime and narcotics trafficking organizations. The agencies are not only focusing on professionals involved in healthcare fraud but also on the current Good Manufacturing Practices (cGMP) of pharmaceutical and medical companies. Recently, cGMP problems have become a source of health care fraud enforcement. The Food and Drug Administration (FDA) is intensifying its prosecution of cGMP laxity and the DOJ is viewing cGMP violations as potential civil or criminal issues. Hence, the challenge of compliance is an increasing problem for everyone in the healthcare industry. Avoiding litigation for fraud or failure to comply with regulations is getting harder than ever. In this CLE course, a panel of notable leaders and professionals assembled by The Knowledge Group will provide the audience with an in-depth review and discussion of the rigid, focused, and sophisticated Healthcare Fraud Enforcement Tactics. The speakers will also provide the audience with a set of best practices to remain in compliance and to avoid healthcare enforcement pitfalls in 2016 and beyond. Key topics include: § The Affordable Care Act created new provisions the government plans to use against health fraud, waste, and abuse. These provisions include new tougher criminal sentences for health fraud convictions, and tougher suspension authority and screening measures over providers. § In June 2015, the DOJ and OIG together coordinated an unprecedented one day takedown of 243 people nationwide for alleged health fraud worth $712 million. The takedown highlights the government’s focus on multiple types of fraud, especially including cases involving medical necessity, home health agencies, and Medicare Part D schemes. § This year, the Office of Inspector General (OIG) has created a new task force that will primarily use both Civil Monetary Penalties and Exclusions from federal healthcare programs to go after alleged health fraud and abuse. The OIG announced that this new task force plans to target individual physicians instead of large healthcare systems. Once targeted, the OIG will pursue administrative actions that are easier to prosecute than actions under the False Claims Act. § Federal agencies are expanding the use of Data Analytics in an effort to become more proactive in detecting potential healthcare fraud. CMS’s Fraud Prevent System and OIG’s Medicare Fraud Strike Force both have a long-term goal to increase the use of technology and data to sniff out fraud sooner instead using the old “pay-and-chase” § Unique enforcement risks facing executives in the health care industry in light of DOJ’s increasing invocation of the Park doctrine and HHS OIG’s broadening authority to exclude individuals from participation in federally funded health care industry § Increased focus on violations of current Good Manufacturing Practices as a basis for criminal liability as well as liability under the False Claims Act § Current trends in criminal and civil enforcement against “off-label promotion” by both drug and device manufacturers in light of recent caselaw Speakers/Faculty Panel Thomas D. Bever Partner Chilivis Cochran Larkins & Bever LLP Patrick F. Linehan Partner Steptoe & Johnson LLP About The Knowledge Group/The Knowledge Congress Live Webcast Series The Knowledge Group brings together the world's leading authorities and industry participants through informative two-hour webcasts that study the impact of changing regulations and help businesses succeed through proper regulatory compliance. Visit http://theknowledgegroup.org/ End
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