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

False Claims Act & the Health Care Industry is intended to help health care lawyers, accountants, executives, and other professionals assess a company’s potential exposure to false claims liability and reform company practices to reduce the risk of liability by providing a comprehensive analysis of the FCA and its interpretation.
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3rd Edition
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ISBN: 9780769884592
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Book Edition: 3E

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This Third Edition of False Claims Act & the Health Care Industry has been prepared in response to False Claims Act (FCA) amendments, the surge of false claims litigation and recoveries, and the rapidly developing case law. It is intended to help health care lawyers, accountants, executives, and other professionals assess a company’s potential exposure to false claims liability and reform company practices to reduce the risk of liability by providing a comprehensive analysis of the FCA and its interpretation. This new edition analyzes legislative changes to:

  • The FCA’s reverse false claims provision; 
  • The FCA’s whistleblower retaliation provision; and
  • The FCA’s public disclosure bar.

In the wake of these changes, courts across the country, including the United States Supreme Court, have issued significant decisions that impact the operation of health care businesses. This book analyzes those decisions, addressing:

  • Defenses that the defendant’s claim is not “false;”  
  • Defenses that the defendant did not “know” that the claim or statement is “false;” 
  • Defenses that the defendant’s knowingly false claims or statements are not “material” to the government’s determination to pay; 
  • The status of actions where the relator’s action repeats public information;  
  • And more.

The eBook versions of this title feature links to Lexis Advance for further legal research options. 

Published April, 2018.

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Table of Contents

CONTENTS


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—§ 3730(a)

Chapter 3:02  Actions by Private Parties—§ 3730(b)


Chapter 3:03  Rights of the Parties in Qui Tam Actions—§ 3730(c)

Chapter 3:04  Award to Qui Tam Plaintiff—§ 3730(d)

Chapter 3:05  Section 3730(e) Bars to Qui Tam Actions—§ 3730(e)

Chapter 3:06  Expenses and Fees for Which the Government is Responsible

Chapter 3:07  Whistleblower Retaliation Provision—§ 3730(h)

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