Heath Care Fraud and Abuse

This seminar will use a practical, case-study approach to some of the issues arising in the complex world of health care enforcement and compliance. With emphasis on the procedural mechanisms of the False Claims Act and the substantive law of the Anti-Kickback Act, the Stark I and II laws, the Food Drug and Cosmetic Act, and the government’s remedial authorities, the seminar will explore how prosecutors, defense attorneys, whistleblowers, and compliance officials inside health care companies approach their work and advise their clients. The seminar will explore the relationships between regulated industries (e.g., pharmaceutical companies, hospitals, doctors, medical device companies) and government insurance programs (e.g., Medicaid and Medicare), why these relationships generate billions of dollars every year in fraud, and how the interested constituencies are approaching these issues. UPPER-CLASS WRITING REQUIREMENT: This class may not be used to satisfy the requirement. **A student who fails to attend the initial meeting of a seminar, or to obtain permission to be absent from either the instructor or the Registrar, may be administratively dropped from the seminar. Students who are on a wait list for a seminar are required to attend the first seminar meeting to be considered for enrollment.