Dealing with Fraud and Waste in Healthcare from a Legal Perspective
Soaring budget deficits have put healthcare under intense scrutiny and subjected an entire industry to a national debate. Providers are increasingly turning to their advisors to help mitigate the risk of fraud and abuse in healthcare as increased government attention and significant legislative and regulatory reform have made the legal landscape more complex than ever.
The Knowledge Group is assembling a panel of experts to help healthcare attorneys and their clients develop a plan to address emerging issues.
The panelists will address key topics, including:
- Preparing company spokesmen: potential pitfalls and strategies to mitigate risk
- Identifying risks and benefits from proactively approaching the government, including HHS-OIG or DOJ
- Managing senior executive risk in light of recent government guidance and enforcement activity
- Addressing emerging issues in the assessment and valuation of litigation or enforcement risky
- Knowledge management
- Whether in the context of lobbying efforts, litigation or compliance, it is critical that company spokesman are well-informed and well-prepared
- Discuss potential pitfalls and strategies to mitigate risks
- Strategy for approaching the government if you choose to do so
- Whether to self-disclose to HHS-OIG or DOJ
- Perks and pitfalls of OIG self-disclosure initiative
- Managing Senior Executive Risk
- 2010 and 2011 has seen a significantly increased focus on executive liability and responsibility
- Discuss current risks and ways to mitigate this risk
- FDA guidelines for Park prosecutions
- HHS-OIG permissive exclusion of executives
- Dodd-Frank and FCA exposure
- Obstruction of justice and false statements exposure
- Valuation of risk
- Whether the context is litigation, internal investigation, a potential transaction, or evaluation of internal policies and procedures, an accurate assessment and valuation of potential risk is critical to strategic decisions
- Discuss emerging issues with assessment and valuation of risk
- Expert testimony extrapolating causation and damages
- How to calculate amounts attributable to conduct in criminal and civil proceedings
Who Should Attend:
- Directors and C-level Managers in healthcare organizations
- Executives and Administrators
- Medical Directors
- Medical Providers
- Compliance Officers
- Health Services Professionals
- Clinical Documentation Specialists
- Health Industry Advisors
- Healthcare Law Attorneys
- Health Care Advisory Services Consultants
- Health Policy Directors
- State Health Executives
- Healthcare Finance Executives
- Healthcare Consultants
- Other Interested/Related Professionals
Ann’s practice includes all aspects of complex commercial litigation, including health care, constitutional, and employment discrimination cases in state and federal trial and appellate courts throughout the country. Prior to joining the firm, Ann was an Assistant United States Attorney for the Southern District of Florida, where she was responsible for a major MDL relating to multi-million dollar Medicare and Medicaid health care fraud by a drug company. In addition, Ann represented the United States in complex employment discrimination cases, successfully defended the constitutionality of a federal law enforcement statute, and defended Department of Justice employees against constitutional challenges brought by a notorious drug kingpin.
Ann also continues to devote a significant amount of time to pro bono matters, and was a member of the litigation team that received the Florida Supreme Court’s Voluntary Bar Association Pro Bono Service award for its representation of 34,000 Cuban detainees held at the Guantanamo Naval Base in 1994. Ann has also represented and served as a guardian ad litem for, on a pro bono basis, numerous severely abused and neglected children.
- Lead co-counsel in nationwide health care multi-district litigation against Abbott Laboratories for average wholesale drug pricing fraud that resulted in $126.5 million settlement.
- Chief counsel responsible for action against major South Florida hospital in false cost-reporting scheme, resulting in multi-million dollar penalties and restitution settlement.
- Chief counsel in 24 coordinated health care fraud cases under Operation Equity Excise, successfully obtaining judgment of hundreds of millions of dollars resulting from defendants’ fraudulently-submitted claims to Medicare for durable medical equipment and unperformed medical procedures.
- Successfully represented numerous federal employees against convicted drug kingpin, Salvador Magluta, who alleged that her clients and the Department of Justice Bureau of Prisons violated his constitutional rights.
- Chief trial counsel defending the United States Department of Homeland Security in Title VII and Rehabilitation Act discrimination matter.
- Chief counsel in case of first impression challenging the constitutionality of the Debbie Smith Act, which enables federal law enforcement to collect DNA from convicted felons for inclusion in the federal CODIS databank, in which the court confirmed the constitutionality of the statute.
- Successfully represented Great Northern Paper Company at trial court level and on appeal, ultimately arguing the appeal to the Maine Supreme Court, preserving Great Northern’s unencumbered title to over a million acres of valuable timberland.
- United States v. Ameritrade Terminals, Inc., 177 Fed.Appx. 855 (11th Cir. 2006)
- In re: Pharmaceutical Industry Average Wholesale Price Litigation, United States of America ex rel. Ven-A-Care of the Florida Keys, Inc. v. Abbott Laboratories, Inc., 491 F. Supp.2d 12 (D. Mass. 2007)
- Magluta v. Wetzel, 2006 WL 3837455 (S.D. Fla. 2006)
- Haines v. Great Northern Paper, 808 A.2d 1246 (Me. 2002)
- Abusing the Privilege: The Crime-Fraud Exception to Rule 501 of the Federal Rules of Evidence, 48 U. Miami L. Rev. 259 (Nov. 1993) SPEAKING ENGAGEMENTS
- Presenter, ABA Health Care Fraud Conference, 2008 GOVERNMENT SERVICE
- Assistant United States Attorney, Southern District of Florida, 2003- 2010
- Antitrust Litigation
- Commercial Litigation
- Employment Practices and Litigation
- University of Miami School of Law (J.D., cum laude, 1994)
- Bowdoin College (A.B., magna cum laude, 1989)
- 1994, Florida
- 1998, Maine
- 1995, U.S. District Court, Southern District of Florida
- 1998, U.S. District Court, District of Maine
- Civil Justice Advisory Committee, Southern District of Florida, 1995-96
- Legal Writing Instructor, University of Miami School of Law, 1994-1997
Ann’s practice includes all aspects of complex commercial litigation, including health care, constitutional, and employment discrimination cases in state and …
KIRSTEN V. MAYER is Counsel at Ropes & Gray LLP in Boston. Ms. Mayer represents corporations and individuals in the health care industry in criminal, civil and administrative matters involving federal and state law enforcement. She represents clients in the pharmaceutical and medical device industries in off-label, anti-kickback and pricing fraud matters. She also represents providers in anti-kickback, Stark, coding, and clinical research billing matters. Ms. Mayer’s practice includes civil False Claims Act, consumer protection and private class action litigation as well as advising clients with respect to fraud and abuse and compliance in the context of internal investigations and strategic transactions in the health care industry. Ms. Mayer is a frequent speaker on health care compliance and fraud and abuse enforcement, and has been a faculty member for National Institute of Trial Advocacy (NITA) programs since 2005.
KIRSTEN V. MAYER is Counsel at Ropes & Gray LLP in Boston. Ms. Mayer represents corporations and individuals in the …
Lisa Noller is a litigation partner with Foley & Lardner LLP, where she is a member of the firm’s Health Care, Medical Devices, and Life Sciences Industry Teams, as well as the Government Enforcement, Compliance & White Collar Defense and Business Litigation & Dispute Resolution Practices. She is an experienced trial lawyer, having spent more than 15 years investigating and trying complex criminal and civil cases, including the only Anti-kickback Statute (AKS) jury trials in the Northern District of Illinois. She was a member of the U.S. Attorney’s team dedicated to the prosecution of health care fraud in Northern Illinois, which worked with the FBI and HHS-OIG to prosecute fraud and abuse and to counsel entities seeking to be compliant with complex regulations. In connection with AKS trials, Ms. Noller submitted and defended pattern jury instructions now used in other AKS cases. Ms. Noller also routinely exercised her discretion in deciding whether to charge or sue individuals or entities suspected of health care fraud, including medical device manufacturers, pharmaceutical companies and hospitals, and worked with other attorneys to make reasonable prosecution decisions. Her practice at Foley focuses on managing risk, responding to government investigations, conducting corporate internal investigations, and litigating a wide variety of civil and criminal matters in state and federal courts. Ms. Noller represents companies and individuals in parallel civil and criminal proceedings initiated by government agencies for alleged wrongdoing, including False Claims Act matters and HHS-OIG investigations, and she proactively counsels clients in health care enforcement and other litigation matters such as Stark compliance reviews.
Lisa Noller is a litigation partner with Foley & Lardner LLP, where she is a member of the firm’s Health …
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About Kasowitz, Benson, Torres & Friedman LLP
Kasowitz, Benson, Torres & Friedman LLP is a national law firm specializing in complex, highly sophisticated litigation numbering more than 350 lawyers. The firm has offices in New York, Houston, Atlanta, San Francisco, Miami and Newark, and plans to open a Silicon Valley office in 2011. For more information, visit www.kasowitz.com.
About Ropes & Gray LLP
With 1,000 attorneys in 10 offices across three continents, Ropes & Gray is a trusted legal advisor to clients in all stages of development across all sectors of the global economy. The range and reach of our results-oriented teams address singularly complex client needs while enhancing their market position. From mission critical transactions to “bet the company” litigation, we work collaboratively with our clients to create the strategies that lead to business success.
About Foley & Lardner LLP
With approximately 900 attorneys in 21 offices, Foley & Lardner LLP provides award-winning business and legal insight to clients nationally and globally. The firm’s team-based approach, innovative technology, and focus on client service and value are continually recognized by its clients and the legal industry. In the recent BTI Consulting Group survey of Fortune 1000 corporate counsel, Foley received a Top 10 ranking out of more than 500 firms for its strong client focus, breadth of service, innovation, and value for the dollar. In addition, Foley was a Top 10 firm on the U.S. News – Best Lawyers® 2010 “Best Law Firms” list, based on the total number of first-tier metropolitan rankings. The firm continues to be a perennial selection for the prestigious CIO-100 List, CIO Magazine’s survey recognizing technological innovation that enhances business value.
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