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

From the time that the Third Edition to False Claims Act & the Health Care Industry was published in 2018, significant events have occurred regarding the government's enforcement and administration of the False Claims Act (FCA) that are outlined in the 2020 Supplement.
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3rd Edition with 2020 Supplement
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False Claims Act & the Health Care Industry is a one-stop source for legislative and case law developments covering the gamut of potential false claims litigation, across all jurisdictions. This publication provides analysis of key arguments, including:

  • 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

The 2020 Supplement to the Third Edition has been prepared in response to the rapidly developing case law. It 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 2020 Supplement includes coverage of:

  • The relator's ability to pursue new claims and defendants after government intervention when the government declines to pursue the relator's additional claims
  • Plaintiff's ability to predicate an FCA action upon subregulatory guidance in light of supervening Supreme Court precedent
  • The government's increasing propensity to seek dismissal of meritless qui tam actions

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Published June, 2020

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Table of 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