AHLA Legal Issues in Health Care Fraud and Abuse (Non-Members)

The need for an understanding of fraud and abuse principles is not limited to lawyers who prosecute or defend against government investigations; it extends to all lawyers advising health care providers on nearly every type of health care transaction in the United States today.
Publisher: AHLA

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Print Book :1 volume, Softbound, 674 pages
5th Edition
ISBN: 9780769881584
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ISBN: 9780769881607
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This completely updated fifth edition offers broad coverage of the full range of U.S. fraud and abuse prohibitions, with practical application for your work in health care today. Completely updated to address the latest trends in investigation, enforcement, and interpretations of the law, this edition of Legal Issues in Health Care Fraud and Abuse addresses the sweeping changes seen in the health care industry since the previous edition, with over 600 pages of expert explanations and fully referenced real-world examples.

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, providing a foundation for your work in health law:

  • How health care is regulated in the United States
  • 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

As health care and society evolve, so too does fraud and abuse law and governmental enforcement activity. Since the previous edition of this book, the risks relating to fraud and abuse have evolved significantly, 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. Every chapter analyzes the impact of these changes.

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The 4th Edition ISBN was 9780769854649.

Published September, 2020.

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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