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Squire Sanders | squiresanders.com
What Keeps YouUp At Night?
Issues of Fraud and Abuse Compliance Series
Squire Sanders | squiresanders.com
Squire Sanders | squiresanders.com
What Keeps YouUp At Night?
Issues of Fraud and Abuse Compliance Series
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Today’s Topic:“What I Don’t See Coming from the DOJ”
Interagency task force called HEAT
New technology to identify and freeze paymentsbefore they are made
Government strategies to: Encourage and prosecute more qui tam suits
Hold more executives accountable
Civil investigative demands and RAC audits
An effective compliance program
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David W. Grauer
Chair, Squire SandersHealthcare Practice
Former Pharmacistwith managementperspectives
Practical and legalperspective tohealthcare issues
Thomas E. Zeno
Firm’s White CollarDefense &Investigations Practice
25 years as AssistantUS Attorney
8 years criminalhealthcare fraudprosecutor
Executive Assistant USAttorney forOperations
Joseph Walker
Former federalprosecutor with DOJ’sCriminal Fraud section
Chair, Squire SandersWhite Collar Defense &Investigations Practice
Fraud prosecution anddefense work
Today’s Speakers
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In it for
the money …
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H.E.A.T. – Health Care Fraud Prevention andEnforcement Action Team
DOJ’S Motto … The HEAT is on
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Predictive Modeling
Fraud programs like creditcard companies
No more “pay and chase”
Government will freezepayments, then investigate
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False Claims Act … The Big Secret
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Relators Can Be:
Whistleblowers
Former or current disgruntled employees
Competitors
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In it for
the money …
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Traditional Fraud Crimes
Mail fraud
Wire fraud
Healthcare fraud
Conspiracy
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New Creative DOJ Approaches
Anti-kickback statute
Off-label marketing
Charging doctors, nurses and healthcareexecutives
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Investigative Tools
Grand jury subpoenas
Administrative subpoenas
Civil Investigative Demand (CID) – 31 U.S.C.§3733(a)(1)
It ain’t necessarily so
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Recovery Audit Contractorsand
Program Safeguard Contractors
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What Should General Counsel Do?
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What Should General Counsel Do?
Establish an effective compliance program Written procedures
Risk based
Clear lines of authority
Get a good compliance officer
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What Should General Counsel Do?
Provide good compliance training
Show commitment at the top to compliance
Use discipline and enforcement
Conduct internal and external audits
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Questions?
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Thanks for Joining Our WebinarJoin us for future calls in this series:
March 15 – Keeping Your CEO From Being Excluded
May 17 – Attorney-Client Privilege: Keeping it and Using itWisely
September 20 – How to Handle the Bad Email or Social MediaPost
Others Pending:
Use of Outside Counsel: When Inside Counsel Is Not Enough
Proper Recordkeeping in Heightened Enforcement Environment
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Thanks For Joining Our Webinar
Contact us with other questions or issues:
David Grauer: [email protected]
Joe Walker: [email protected]
Tom Zeno: [email protected]
Squire Sanders | squiresanders.com
What Keeps YouUp At Night?
Issues of Fraud and Abuse Compliance Series