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

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Print Book :1 Volume, Softbound, 1080 pages
3rd Edition
ISBN: 9780769884578
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ISBN: 9780769884592
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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.

Authors / Contributors

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