AHLA Legal Issues in Health Care Fraud and Abuse (AHLA Members)
Now includes the 2024 Cumulative Supplement to the Fifth Edition that provides an update on numerous legal developments under the False Claims Act, including two Supreme Court cases decided in 2023 and an overview of significant settlements of FCA cases.
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Subscribers receive the product(s) listed on the Order Form and any Updates made available during the annual subscription period. Shipping and handling fees are not included in the annual price.
Subscribers are advised of the number of Updates that were made to the particular publication the prior year. The number of Updates may vary due to developments in the law and other publishing issues, but subscribers may use this as a rough estimate of future shipments. Subscribers may call Customer Support at 800-833-9844 for additional information.
Subscribers may cancel this subscription by: calling Customer Support at 800-833-9844; emailing customer.support@lexisnexis.com; or returning the invoice marked 'CANCEL'.
If subscribers cancel within 30 days after the product is ordered or received and return the product at their expense, then they will receive a full credit of the price for the annual subscription.
If subscribers cancel between 31 and 60 days after the invoice date and return the product at their expense, then they will receive a 5/6th credit of the price for the annual subscription. No credit will be given for cancellations more than 60 days after the invoice date. To receive any credit, subscriber must return all product(s) shipped during the year at their expense within the applicable cancellation period listed above.
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Legal Issues in Health Care Fraud and Abuse offers broad coverage of the full range of U.S. fraud and abuse prohibitions, with practical application for your work in health care today. Addressing the latest trends in investigation, enforcement, and interpretations of the law, author Laura Laemmle-Weidenfeld explains the sweeping changes seen in the health care industry, with over 600 pages of fully referenced real-world examples, updated annually with a cumulative supplement.
The need for an understanding of fraud and abuse principles is not limited to lawyers who prosecute or defend government investigations; it extends to all professionals advising health care providers on nearly every type of health care transaction. With in-depth coverage of the Anti-Kickback Law, Stark Law, False Claims Act, and more, this book is a necessity for anyone who needs to understand the intricacies of how fraud and abuse laws are structured and enforced in the health care context, covering:
- How health care is regulated in the U.S.
- How fraud and abuse laws are enforced by federal and state entities
- Practical advice on assessing and addressing risk
- Guidance on navigating relationships with the agencies and individuals enforcing the law’s prohibitions
The risks relating to fraud and abuse continue to evolve, for reasons ranging from the proliferation of health care data, to the expansion of the use of technology in health care, to changes in the regulatory scheme resulting from the shift toward value-based payment. Cumulative annual supplements keep you current by incorporating new rulemaking, advisory opinions, waivers, settlements, enforcement trends, and more.
eBooks, CDs, downloadable content, and software purchases are noncancelable, nonrefundable and nonreturnable. Click here for more information about LexisNexis eBooks. The eBook versions of this title may feature links to Lexis+® service for further legal research options. A valid subscription to Lexis+ is required to access this content.
The 4th Edition ISBN was 9780769854632.
Published September, 2020, with August 2024 Cumulative Supplement.
Featured Authors
Laura F. Laemmle-Weidenfeld
Laura Weidenfeld is a partner in the Health Care and Life Sciences practice at Jones Day in Washington DC. Drawing on her extensive experience defending clients against health care fraud enforcement actions, Laura also provides practical compliance advice on Medicare and Medicaid fraud and abuse issues. She defends against numerous investigations and litigation brought by the Department of Justice (DOJ), various U.S. Attorney's offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), state attorneys general, and other state and federal agencies.
Laura also helps her clients navigate challenging compliance issues, including analyzing arrangements under the Stark Law and Anti-Kickback Statute, conducting internal investigations, and preparing self-disclosures.
Earlier in her career, Laura served as a trial attorney in the Frauds Section of the DOJ's Civil Division, where she conducted health care fraud investigations and litigation matters brought under the False Claims Act (FCA) and its whistleblower (or qui tam) provisions.
Laura regularly speaks and writes on health care fraud and abuse issues and has been an active member of the American Health Law Association for over 15 years. She received her JD from Georgetown University Law Center and her BA and BM from Northwestern University.
Table of contents
1 The Fraud Enforcers: Who Are They and What Do They Do?
2 Federal Anti-Kickback Laws
3 Federal Physician Self-Referral Prohibitions
4 Administrative Sanctions Available to Federal Enforcers
5 The False Claims Act and Other Means of Federal Enforcement of Health Care Fraud
and Abuse Laws
6 State and Private Initiatives to Combat Fraud
7 Compliance and Self-Reporting
