The health care industry is extremely complex; learn how to navigate health care law and HIPAA Privacy and Security.
Health care organizations continue to face a significant number of federal government enforcement actions premised on allegations that claims submitted to government health care programs were not medically necessary, not documented appropriately, or failed to meet complicated coding and billing rules and regulations, among a litany of other theories that can give rise to liability under the federal False Claims Act (FCA). Listen along as Stuart Gerson and Daniel Fundakowski discuss recent trends in federal FCA enforcement, highlight the key FCA case law and regulatory developments from 2020, describe strategies to identify compliance and mitigate enforcement risk, and explain what regulated entities should expect and be wary of in 2021 and beyond.
Stuart M. Gerson
Epstein Becker & Green, P.C.
- Former Acting Attorney General of the United States, Assistant Attorney General, and federal prosecutor with hands-on enforcement and policy experience both with respect to antitrust and data privacy and security
- Experience in counseling and defending companies in antitrust litigation, including the successful court defenses of recent hospital mergers and other health care-related cases
- Successful defense of class action litigation related to the privacy of both PII and PHI
- Broad successful litigation and counseling experience with respect to Federal False Claims Act and other fraud actions
- As a corporate director, head of a compliance committee in a heavily data-centric industry
- Director of National Council of Registered ISAO’s, related to the adoption of best cyber practices and the fostering of public/private partnerships
Epstein Becker & Green, P.C.
- Senior counsel with Epstein Becker Green in its Washington, D.C. office
- Practice focuses on representing health care clients in civil and criminal litigation matters, including matters arising under the False Claims Act (FCA)
- Has experience litigating FCA cases that are predicated on allegations of upcoding, medical necessity, off-label promotion, research cost mischarging, and improper reporting of usual and customary prices, among other theories giving rise to FCA liability
- Also frequently designs and implements compliance programs, conducts internal investigations, and advises health care clients on how to prepare for and respond to inquiries and audits conducted by the federal government, state attorneys general, and government contractors
- Regularly writes and speaks on health care enforcement trends and developments
- Can be reached at (202) 861-1826 or [email protected]
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