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AHLA False Claims Act & The Health Care Industry: Counseling & Litigation (Non-Members)

Significant events have occurred regarding the government's enforcement and administration of the False Claims Act (FCA) that are outlined in this Fourth Edition of False Claims Act & the Health Care Industry.

Publisher: AHLA

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ISBN/ISSN: 9781663338501
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In this Fourth Edition of False Claims Act & the Health Care Industry, author Robert S. Salcido incorporates his analysis of recent applications of the law by federal district courts, circuit courts of appeal, the United States Supreme Court, and relevant federal agencies through January 21, 2022. Areas of evolving False Claims Act (FCA) interpretation include:

  • What link must exist where an alleged FCA violation is based on an alleged violation of the Anti-Kickback Statute
  • The necessity that relators alleging a corporate-wide scheme furnish corporate-wide proof
  • Application of the FCA's statute of limitations tolling provision to relators
  • Whether claims are false when alleged facts are consistent with both misconduct and an obvious alternative explanation in accordance with the law
  • Whether a false implied representation must be linked to specific codes and factual representations on the claim form
  • Whether a case should be dismissed if a plaintiff relies on subregulatory guidance to establish falsity
  • How courts have applied a “holistic” test to determine whether a false representation is material to the government's determination to pay
  • Whether relators can pursue additional claims against the defendant once the government intervenes
  • What the government must show to dismiss qui tam actions over a relator's objection
  • Updates to the Health Care Fraud Self-Disclosure Protocol
  • And more

This comprehensive reference is intended to assist health care lawyers, accountants, executives, and other professionals assess a health care company's potential exposure to liability, evaluate the exposure of companies that may be acquired, and reform company practices to reduce the risk of potential FCA liability.

The ISBN for the 3rd Edition was 9780769884578.

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Published June, 2022

 

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Table of contents

 Recent Titles from the American Health Law Association Preface
About the Author
About the American Health Law Association Scope
Dedication Acknowledgements
Second Edition Acknowledgements

Part 1  False Claims Act History
Chapter 1:00  Congressional Goals in Passing and Amending the Statute
Chapter 1:01  The 1863 Act and Its Immediate Aftermath
Chapter 1:02  The 1943 Act
Chapter 1:03  Case Law Developments Before the 1986 Amendments
Chapter 1:04  The 1986 Act
Chapter 1:05  The 2009 False Claims Act Amendments
Chapter 1:06  The 2010 Amendments to the False Claims Act

Part 2  Application of the False Claims Act Substantive Provisions
Chapter 2:00  Substantive Provisions of the False Claims Act: An Introduction
Chapter 2:01  The Meaning of "Person" Under the False Claims Act
Chapter 2:02  The Meaning of "Cause" to Present a False or Fraudulent Claim
Chapter 2:03  False or Fraudulent Under the FCA
Chapter 2:04  An FCA "Claim," "Record," or "Statement" and Presentment Under
 Subsections 3729(a)(1)(A) and (a)(1)(B)
Chapter 2:05  Knowledge Under the False Claims Act
Chapter 2:06  Materiality
Chapter 2:07  Conspiracy
Chapter 2:08  Reverse False Claims

Part 3  Civil Actions for False Claims
Chapter 3:00  Qui Tam Provisions: An Introduction
Chapter 3:01  Responsibilities of Attorney General—Section 3730(a)
Chapter 3:02  Actions by Private Parties—Section 3730(b)
Chapter 3:03  Rights of the Parties in Qui Tam Actions—Section 3730(c)
Chapter 3:04  Award to Qui Tam Plaintiff—Section 3730(d)
Chapter 3:05  Section 3730(e) Bars to Qui Tam Actions—Section 3730(e)
Chapter 3:06  Expenses and Fees for Which the Government Is Responsible
Chapter 3:07  Whistleblower Retaliation Provision—Section 3730(h) Establishes a Prima
 Facie Violation
Chapter 3:08  Discovery in Relator-Only Lawsuits
Chapter 3:09  Application of Fed. R. Civ. P. 9(b) to the False Claims Act

Part 4  Damages and Civil Penalties
Chapter 4:00  The Computation of Damages and Civil Penalties Under the FCA: An
 Introduction
Chapter 4:01  Pre-1986 Cases Regarding the Scope of Damages Under the FCA
Chapter 4:02  The 1986 Legislative Amendments
Chapter 4:03  FCA Damages: Principles and Proof
Chapter 4:04  Practice Areas Raising Damage Issues
Chapter 4:05  Civil Penalties
Chapter 4:06  Constitutional Limitations on Civil Penalties

Part 5  False Claims Act Procedure and Jurisdiction
Chapter 5:00  Introduction
Chapter 5:01  False Claims Procedure
Chapter 5:02  FCA Jurisdiction

Part 6  Civil Investigative Demands
Chapter 6:00  CIDs: An Introduction
Chapter 6:01  CIDs as Administrative Subpoena
Chapter 6:02  Compliance with the Terms of Section 3733
Chapter 6:03  Relevance and Undue Burden
Chapter 6:04  Bad Faith and Abuse of Process
Chapter 6:05  Responding to the CID

Part 7  The Voluntary Disclosure Program
Chapter 7:00  Submitting a Voluntary Disclosure: An Introduction
Chapter 7:01  The Operation of the Inspector General's Voluntary Disclosure Program
Chapter 7:02  The Benefits and Risks Associated with Voluntary Disclosures
Chapter 7:03  Settling the Matter Table of Cases

Index