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What's the Government Up To?: Enforcement Trends in Health Care Fraud and False Claims Act Prosecution


Level: Advanced
Runtime: 92 minutes
Recorded Date: October 18, 2017
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Agenda

  • Yates Memo and Lessons from Recent Trials
  • AKS & Marketing Arrangements
  • Compounding Pharmacies
  • Symbiosis Between Laboratories and Rehabs/Addiction Treatment Centers
  • Opioid Epidemic and “Theme Prosecutions”
  • Substandard Care/Worthless Services – Personal Care Services (PCS) and quality
Runtime: 1 hour and 32 minutes
Recorded: October 18, 2017

Description

webinar will cover practical strategies for defending clients against a civil or criminal health care fraud investigation or prosecution.

Significant decisions interpreting the False Claims Act and the Anti-Kickback statute, including recent False Claims Act jurisprudence interpreting the Escobar decision and the impact of Escobar will be discussed by panelists including government and defense attorneys. Recent enforcement trends in prosecutions of physicians, hospices, hospitals, skilled nursing facilities, pharmacies, and sales and marketing professionals will also be covered, as well as a candid conversation about the criterion used by the government to determine when a burgeoning prosecution will "remain civil." Finally, panelists will suggest practical strategies for defending clients against a civil or criminal health care fraud investigation or prosecution.

This program was recorded on October 18th, 2017.

Provided By

American Bar Association
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Panelists

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Jessica R. Sievert

Assistant U.S. Attorney
United States Attorney's Office, Eastern District of Tennessee

Jessica R. Sievert is the Assistant US Attorney in the Eastern District of Tennessee.

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Andrew S. Feldman

Founder
Feldman Firm, PLLC

Andrew S. Feldman is the founder of Feldman Firm, PLLC. His practice concentrates on representing individuals and small business in white collar criminal matters, government investigations targeting health care fraud, tax violations, and securities violations, and civil litigation involving theft, fraud, or misappropriation, in state and federal courts. Mr. Feldman has represented individuals in jury trials in federal criminal and civil cases and has represented individuals in grand jury investigations and proceedings and has counseled clients in investigations initiated by the FBI, various Offices of Inspector Generals (OIG), the Internal Revenue Service, Drug Enforcement Administration, Environmental Protection Agency, and the Securities and Exchange Commission. Mr. Feldman also has experience in False Claims Act litigation, fraud litigation, tax cases and controversies, administrative proceedings, extradition proceedings, FINRA arbitrations, and suspension and debarment matters.

Prior to founding the Firm, Mr. Feldman worked for more than five years under Neal Sonnett, a nationally renowned white collar criminal defense attorney and former president of the National Association of Criminal Defense Lawyers (NACDL). Mr. Feldman also worked at a national firm where his practice focused on white collar criminal defense, civil litigation, and corporate compliance matters. Mr. Feldman has defended individuals under investigation for or charged with federal tax crimes, environmental crimes, health care fraud, controlled substances diversion, violations of the Anti-Kickback statute, securities fraud, bribery, complex conspiracies to defraud government agencies, and other economic crimes.

Mr. Feldman is active within the American Bar Association (ABA). He has been featured as a panelist at the ABA’s annual White Collar Crime Committee meeting and he has served as a co-chair of the Young Lawyers Committee for that Committee for five years. Mr. Feldman also serves on the Health Care Fraud & Abuse and Compliance Committee of the ABA’s Health Law Section and is a co-chair of the ABA’s Small and Solo Firm Committee for the ABA’s Criminal Justice Section. Feldman Firm PLLC is also a former member of the South Florida Hospital and Health Care Association (SFHHA).

Mr. Feldman also strongly believes in serving the interests of the local community and representing individuals who cannot afford to hire competent counsel. To that end, Mr. Feldman has represented clients pro bono in civil and criminal matters and has obtained dismissals of criminal charges on behalf of clients in state court.

Prior to his admission to practice law in Florida, New York, and District of Columbia, Mr. Feldman served as a law clerk for two U.S. Attorneys’ Offices and a certified legal intern for the Miami-Dade State Attorney’s Office where he worked closely with several federal and state prosecutors. He also worked on a year-long project at the Antitrust Division of the U.S. Department of Justice where he assisted in the review of a billion-dollar telecommunications acquisition.

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B. Scott McBride

Partner
Baker & Hostetler LLP

Scott McBride concentrates his practice on providing legal services to the healthcare industry with an emphasis on compliance and enforcement issues, including representing and advising hospitals, academic medical centers, physician groups, and other healthcare clients. He represents and advises clients in overpayment disputes, False Claims Act litigation, internal and external investigations, and regulatory enforcement proceedings, including matters related to Medicare and Medicaid billing compliance, Civil Monetary Penalties, Stark and anti-kickback laws, corporate oversight, and exclusions from federal and state healthcare programs. He also counsels clients in comprehensive corporate compliance matters, including assisting and advising clients on internal investigations, self-disclosures, and repayment matters.

Scott advises clients on Medicare, Medicaid, and other government reimbursement and coverage matters. He represents clients in certain business transactions and financial arrangements, and also represents clients in healthcare matters before state and federal agencies and through administrative appeals, including claims appeals of Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), and other Medicare and Medicaid contractors and payors. Scott also represents clients in payment disputes and recovery activities involving commercial payors.


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