Attention:

Enforcement Actions and Compound Pharmacies


Level: Advanced
Runtime: 94 minutes
Recorded Date: May 17, 2017
Click here to share this program
Download PDF

Agenda

  • The Compound Drug Scheme
  • Fact patterns and trends
  • Data mining and target selection
  • Government Enforcement Tools
  • Other consequences
  • TRICARE Rules
  • Advice of Counsel Defense
  • The Yates Memo
  • Future enforcement trends
Runtime: 1 hour and 34 minutes
Recorded: May 17, 2017

Description

Recent settlements and reported investigations of alleged fraud and abuse by compounding pharmacies highlight the government's increase level of scrutiny over the industry. Billings to the TRICARE program have received the bulk of the government's attention. Panelists will address recent enforcement activity in the industry and what enforcement may be expected in the future.

This program was recorded on May 17th, 2017.

Provided By

American Bar Association

Panelists

Jason Paul Mehta

Assistant US Attorney
USAO

Jason Paul Mehta is an Assistant US Attorney at the U.S. Attorney's Office.

Elizabeth D. Shaw

Partner
RezLegal

Elizabeth Shaw limits her practice to health care matters. Ms. Shaw is Board Certified as a Specialist in Health Law by the Florida Bar Association. She also is a registered nurse and a licensed health care risk manager in the State of Florida, with more than 25 years of clinical, management and legal experience. She combines her legal expertise with her extensive experience in nursing, risk management and the health care industry to provide clients with advice on a broad range of transactional and regulatory legal matters, including contracting, corporate compliance, joint ventures, mergers and acquisitions of health care entities, medical staff issues, physician office operational issues (solo-practitioner to multi-specialty group practices), structuring physician financial arrangements and compensation methodologies, structuring ancillary services (lab, imaging, pharmacy, physical therapy), facility licensure, physician disciplinary cases, HIPAA compliance, Medicare and third party payor audits and reimbursement matters.

She has extensive experience in analyzing and structuring complex health care arrangements to comply with federal and state fraud and abuse statutes, including, but not limited to, the Stark Law, federal and state anti-kickback statutes, federal and state false claims acts, state physician self-referral laws, fee-splitting laws and state licensing laws.

Elizabeth is a frequent lecturer and author on various health care topics. She is a member of the Health Law Section of The Florida Bar, the Health Law Section of the Jacksonville Bar Association and the American Health Lawyers Association.

Daniel Bernstein

Assistant United States Attorney
USAO-SDFL

Dan Bernstein has been with the USAO-SDFL since 2006. From 2012 through January of 2017 he was a deputy chief in the Economic Crimes Section and responsible for supervising the health care fraud unit.

Since Joining the USAO, Dan has tried health care fraud cases, mortgage fraud cases and tax fraud cases. From 1994 to 2006, Dan was an Assistant State Attorney in Miami-Dade County. As an ASA Dan tried over 70 jury trials ranging from DUI to first degree murder.

Dan obtained his B.A. from Washington University in St. Louis and his JD from University of California, Hastings College of the Law.

Marissel Descalzo

Partner
Tache, Bronis, Christianson and Descalzo, P.A.

Marissel Descalzo is a trial attorney and focuses her practice on complex criminal and civil litigation in both federal and state court. Ms. Descalzo has participated in numerous trials to verdict. Ms. Descalzo handles criminal and civil matters of vital importance to clients’ businesses or their personal lives. She represents individuals and organizations accused of fraud and/or deceptive practices, and assists and advises organizations on corporate governance and compliance matters, including in the area of anti-money laundering. Ms. Descalzo represents hospitals, skilled nursing facilities, pharmacies, and other health care providers, during government investigations and defends them in qui tam (whistle-blower) actions. Ms. Descalzo regularly counsels companies from a variety of industries on the adoption and operation of their compliance programs and, in particular, assists companies in the food and beverage industry with internal investigations and ethics issues.

Ms. Descalzo also represents victims of fraud in federal criminal proceedings during all stages of the criminal process. She has a unique service helping victims—whether businesses or individuals—present criminal cases to prosecutors. Most importantly, she represents victims during the sentencing and restitution proceedings in order to optimize the return of the victim’s funds.

Finally, she has significant experience working with companies in connection with data security and privacy issues. She leads teams responding to data breaches and works with companies and law enforcement investigating potential threats to patient privacy and security.

Ryan K. Stumphauzer

Partner
Stumphauzer & Sloman, PL

Ryan Stumphauzer is an AV Preeminent rated attorney who has been recognized by Chambers & Partners as a top practitioner in the area of White-Collar Crime & Investigations. Mr. Stumphauzer represents clients in government regulatory enforcement matters, white collar criminal litigation, internal investigations, whistleblower suits and fraud-related civil litigation.

Prior to founding Stumphauzer & Sloman, Mr. Stumphauzer served for over six years as a federal prosecutor in the Southern District of Florida, where he personally directed hundreds of cases involving allegations of health care fraud, mail and wire fraud, securities fraud, bank fraud, money laundering, identity theft, and violations of HIPAA and the Anti-Kickback Statute. While at the U.S. Attorney’s Office, Mr. Stumphauzer served as the Deputy Chief of the Health Care Fraud Unit, and was also a founding member of South Florida’s highly-publicized Medicare Fraud Strike Force. Prior to his service as a federal prosecutor, Mr. Stumphauzer was a senior accountant at an international accounting firm, where he performed audit and business advisory services for Fortune 500 corporations. Mr. Stumphauzer’s financial background, as well as his extensive experience and leadership in the area of health care fraud and abuse, makes him a valuable asset to corporations and executives in regulated industries.

Mr. Stumphauzer is a frequent speaker and media commentator on health care fraud, financial fraud, and white-collar criminal defense issues. Mr. Stumphauzer is also an active member of the Southern District of Florida federal bar, where he serves as the Co-Chair of the Bench & Bar Committee, and a Member of the Federal Magistrate Judge Merit Selection Panel, Federal Criminal Litigation Committee, the Ad Hoc Committee on Rules and Procedures, and the Ad Hoc Committee on Attorney Admissions, Peer Review, and Attorney Grievance.


Similar Courses

Card image cap
92 minutes
#MeToo: Empowering Employees and Employers to Address Workplace Sexual Harassment & Violence
Join our expert attorneys as they discuss how employers can work to prevent and eliminate sexual harassment and violence in their workplace, and create an environment in which employees are able to respond to and report incidents without fear of retaliation. Not only is there a deep moral imperative to rectify sexual harassment in the workplace and promote an equitable work environment, but also there is significant monetary liability as a potential consequence for employers who fail to address harassment in the workplace.

American Bar Association

$115

Add to Cart
Card image cap
77 minutes
§ 363 Sale Issues
Dive into Section 363 sales issues, including whether there are limits to “free and clear”; the GM conflict between Sections 365(h) and 363(f) (“lease-stripping”); sales free and clear of leasehold interests, restrictive covenants and override royalties; being free and clear of successorships in CBAs; selling free and clear of environmental liabilities (La Paloma, Exide); and loan-to-own strategies.

American Bankruptcy Institute

$75

Add to Cart
Card image cap
63 minutes
2018 CA Consumer Privacy Act: The Big Tail Wagging the U.S.
In this session, two leading information governance attorneys will share why you need to and how you can be ready.

Legalweek

$65

Add to Cart
Card image cap
59 minutes
2018 Global Discovery: International Compliance in the Cloud
Join us for a session examining legal and regulatory changes in store for 2018 and best practices for compliance in the cloud.

Legalweek

$65

Add to Cart
Next