Health care fraud guide

<body bgcolor="white"> <div align="left"><table border="0" cellpadding="0" cellspacing="0" width="500"> <tr> <td colspan="2" valign="top"><p align="center"><a href="AF_frm.htm" target="_top">About the Firm</a> | <a href="fca_f.htm" target="_top">The False Claims Act</a> | <a href="wr_f.htm" target="_top">Whistleblower's reward</a> | <a href="caintr_f.htm" target="_top">Have a case?</a><a href="story_f.htm" target="_top"><br> Whistleblowers' stories</a> | <a href="resman_f.htm" target="_top">Resources</a> | <a href="what_f.htm" target="_top">What's new</a> </td> </tr> <tr> <td><font SIZE="4" COLOR="#333366">Articles by Phillips & Cohen </font> </td> <td valign="top"><img src="../../GIF/PC_url.GIF" width="143" height="14" align="right"></td> </tr> <tr> <td colspan="2"><p align="center"><br> <font size="5"><b>Health care fraud guide </b></font></p> <p>Phillips & Cohen wrote <i>The Healthcare Providers Guide to Whistleblower Lawsuits and the False Claims Act</i> to help health care providers -- who face the potential of false claims liability every day -- as well as their employees better understand the False Claims Act and what happens before and after a whistleblower lawsuit is filed. </p> <p>The monograph, published in 1997, was written at the request of Washington G-2 Reports, an independent publishing company that specializes in newsletters, reference manuals and other publications for the health care industry.</p> <p>Below is the table of contents from <i>The Health Care Providers Guide to Whistleblower Lawsuits and the False Claims Act.</i> For more information, contact:</p> <p><a href="http://www.washg2.com" target="_top">Washington G-2 Reports</a> <br> 1111 14<sup>th</sup> St NW, Suite 500<br> Washington, DC 20005-5663<br> Tel: 800/LAB-REGS (800/522-7347)<br> Fax: 202/289-4062 </p> <p align="center"><i><b>The Healthcare Providers Guide to Whistleblower Lawsuits and the False Claims Act </b></i></p> <p align="center"><b>Contents</b></p> <p>Chapter 1: The False Claims Act & the healthcare industry - - an overview<br> </td> </tr> </table> <li>Whistleblower lawsuits on the rise </li> <li>Health care industry targeted </li> <li>Enforcement initiatives escalate </li> <li>Whistleblower lawsuits spur other cases </li> <li>Criminal penalties for Medicare fraud </li> <li>A compliance program well-crafted <p>Chapter 2: The False Claims Act: from the Civil War to the Cold War<br> </p> </li> <li>The Civil War </li> <li>1943 amendments to the act </li> <li>1986 amendments to the act <p>Chapter 3: Healthcare providers liability under the False Claims Act<br> </p> </li> <li>Actions that create liability<br> </li> <li>Typical violations by healthcare providers<br> </li> <li>Matters excluded from false claims liability <br> </li> <li>Matters already the subject of a civil proceeding<br> </li> <li>Actions based upon matters publicly disclosed<br> </li> <li>Liability for false claims against the states <p>Chapter 4: Qui Tam (whistleblower) provisions of the False Claims Act </p> </li> <li>The role of the relator<br> </li> <li>Shared recovery<br> <p>Chapter 5: False Claims Act violations<br> </p> </li> <li>Elements of a cause of action<br> </li> <li>Kickbacks or false certification may make claims "false"<br> </li> <li>Statute of limitations<br> <p>Chapter 6: Penalties and damages under the False Claims Act<br> </p> </li> <li>Attorneys' fees<br> </li> <li>Criminal and administrative remedies<br> <p>Chapter 7: Employment protection for whistleblowers</p> <p>Chapter 8: The False Claims Act and other anti-fraud laws<br> </p> </li> <li>Other federal anti-fraud laws<br> </li> <li>Alternative administrative remedies<br> <p>Chapter 9: Avoiding or minimizing False Claims Act liability: corporate compliance programs<br> </p> </li> <li>Designing an effective compliance program<br> </li> <li>Reduced penalties<br> <p>Chapter 10: Voluntary disclosures of Medicare fraud<br> </p> </li> <li>Voluntary disclosure can reduce liability </li> <li>HHS' voluntary disclosure pilot program <p>Chapter 11: Anatomy of a False Claims Act case<br> </p> </li> <li>Procedures for filing a false claims (qui tam) lawsuit<br> </li> <li>The government's decision to intervene<br> </li> <li>Final resolution<br> </li> <li>Terms of settlement<br> </li> <li>The whistleblower's award<br> <p>Chapter 12: The False Claims Act and the clinical lab industry<br> </p> </li> <li>National Health Laboratories Inc.<br> </li> <li>MetPath, MetWest and Unilab<br> </li> <li>Damon Clinical Laboratories Inc.<br> </li> <li>Roche Biomedical Laboratories Inc. and National Health Laboratories Inc. (Laboratory Corp. of America Holdings)<br> </li> <li>Spectra Laboratories Inc.<br> </li> <li>SmithKline Beecham Clinical Laboratories Inc.<br> </li> <li>Hospital outpatient laboratories <p>Appendices<br> </p> </li> <li>The federal False Claims Act<br> </li> <li>State and District of Columbia false claims statutes<br> </li> <li>Model compliance program for clinical laboratories, HHS Office of Inspector General<br> </li> <li>Examples of actual health care fraud schemes<br> </li> <li>Sample settlement agreement<br> </li> <li>The PATH (Physicians at Teaching Hospitals) initiative, HHS Office of Inspector General, letter of explanation<br> <br> <p align="center"><br> <br> <br> <font SIZE="1">© 1998 Phillips and Cohen. All rights reserved<br> <a HREF="cred_f.htm" TARGET="_top">Credits</a></font> </p> </li> </div> </body>