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Fraud and Abuse in 2013: Mapping Trends, Strengthening Compliance and Avoiding FCA Actions

Fraud and Abuse in 2013: Mapping Trends, Strengthening Compliance and Avoiding FCA Actions
Product Code - LGA188
Speaker(s): Robert A. Hussar, Manatt, Phelps & Phillips, LLP; Jacqueline C. Wolff, Manatt, Phelps & Phillips, LLP
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Heightened government scrutiny, driven by increasingly strict fraud and abuse provisions, has raised the bar—and the risks—for life sciences companies. In 2012, the Department of Justice recovered $4.96 billion under the False Claims Act, more than $3 billion of that from health care cases. Clearly, health care is under a microscope, and the scrutiny is growing. The Department of Justice is reaching beyond the usual health care statutes to go after life sciences and health care companies in an expanding array of areas—from mail and wire fraud to obstruction—and using more aggressive techniques than ever before, including wire taps and video recordings.

The Department of Health and Human Services (HHS) also has new tools. It now uses predictive modeling to identify fraud and even more demanding corporate integrity agreements. In addition, the Affordable Care Act (ACA) raises penalties up to six times loss or gain for False Claims Act violations in connection with an exchange.

This program helps life sciences and health care companies safely navigate today’s increasingly stringent and complex enforcement environment. It also provides a guide to building and implementing effective compliance programs. Attendees will gain insight into their most critical questions, including:

• What emerging regulations and trends are critical for life sciences and health care companies to be tracking?
• How can institutions and companies strengthen compliance programs to safeguard their organizations including their individual executives?
• What actions should companies take to protect themselves in an increasingly complex enforcement environment?
• How can organizations avoid actions and respond effectively, if they do face an inquiry?

As an added bonus, attendees will be able to download a complimentary copy of a related article from Bloomberg BNA’s Health Care Fraud Report™.

Educational Objectives:

• Learn significant legislative and regulatory developments.
• Understand new enforcement trends for investigating anti-kickback violations, off-label pharmaceutical marketing, and Medicare Part D violations and predictive modeling.
• Discover concrete actions for creating and measuring strong compliance programs—and demonstrating their effectiveness.
• Gain practical recommendations for preparing for and responding to inquiries.

Who would benefit most from attending this program?

The program would be highly valuable for general counsel, officers, managers or directors of compliance, directors and managers of risk services, COOs and CEOs, and outside counsel who practice in the life sciences and/or healthcare spaces.

Program Level: Intermediate.

Credit Available: CLE. For additional information, please see the “CLE Credit” tab.

Robert A. Hussar, Manatt, Phelps & Phillips, LLP; Jacqueline C. Wolff, Manatt, Phelps & Phillips, LLP

Robert A. Hussar, Manatt, Phelps & Phillips, LLP
Robert Hussar has 15 years of experience in the public and private sectors providing advice and strategic direction on Medicare, Medicaid and other payor regulatory, compliance and reimbursement issues. He counsels providers and other healthcare stakeholders on the development and implementation of compliance programs, conducts internal investigations, provides public policy and strategic planning, and advises on Medicare and Medicaid regulatory matters.

Mr. Hussar previously served as the First Deputy for the New York State Office of the Medicaid Inspector General (OMIG), where his role included strategic planning and leadership for New York’s $50 billion Medicaid program. He was directly responsible for the implementation of mandatory provider compliance plans and corporate integrity agreements, and he chaired provider advisory committees focused on compliance guidance, self-disclosures and OMIG’s audit processes.

Mr. Hussar earned a J.D. from Western New England College School of Law and an M.S. in Health Systems Management and a B.A. in Economics and Psychology from Union College.

Jacqueline C. Wolff, Manatt, Phelps & Phillips, LLP
Jacqueline Wolff has spent more than 20 years defending companies and individuals accused of a wide array of white collar crimes. A former Chief of the Environmental Crimes Unit and Assistant United States Attorney for the District of New Jersey, Ms. Wolff focuses her practice on violations of the Foreign Corrupt Practices Act (FCPA), healthcare fraud, securities fraud, Food, Drug & Cosmetic Act (FDCA) violations, tax crimes, corporate immigration crimes and other regulatory-based violations. For years she has successfully defended her clients, from a Fortune 100 company being investigated by the SEC for false financial filings to an individual being investigated by the Department of Justice for tax crimes. Ms. Wolff’s experience as both a prosecutor and defense lawyer has provided her with the depth and understanding to assist companies in designing compliance programs to address FCPA and global anti-corruption issues. She has designed FCPA compliance programs for companies in industries as diverse as those in media, pharmaceuticals, sports, green technology and telecommunications.

While with the United States Attorney’s Office, Ms. Wolff received numerous awards, including those from the U.S. Nuclear Regulatory Commission, Immigration and Naturalization Service, Environmental Protection Agency and the Attorney General of the United States. Ms. Wolff regularly is sought out by business publications and CLE sponsors to speak on FCPA, criminal immigration and FDCA issues. She has written extensively on various criminal defense topics and, in particular, FCPA compliance.

Ms. Wolff earned a J.D. from Fordham University School of Law, where she was named to the Dean’s List with Distinction, Fordham Law Review, and B.A. in Biology/Sociology from the University of Pennsylvania.

This program’s CLE-credit eligibility varies by state. Bloomberg BNA is an accredited provider in the states of New York*, California, Pennsylvania, Texas and Virginia, and most other jurisdictions grant CLE credit on a per-program basis. At this time, Bloomberg BNA does not apply directly to the states of Florida, Rhode Island, Montana and Hawaii although credit is usually available for attorneys who wish to apply individually. Additionally, the following states currently do not grant credit for Bloomberg BNA OnDemand programming: Arkansas, Ohio, Nebraska, and Delaware. All requests are subject to approval once the live webinar has taken place or the customer has viewed the OnDemand version. Please contact the Bloomberg BNA accreditations desk if you have specific questions that have not been addressed.

If you have further questions regarding a specific state or how to file for CLE credit, please contact Bloomberg BNA customer service at 800-372-1033 and ask to speak to the CLE Accreditation Coordinator.

Hardship Policy
Bloomberg BNA offers a hardship policy for attorneys earning less than $50,000 per year. If an attorney wishes to take advantage of this option, he or she must contact Bloomberg BNA directly. For attorneys who are unemployed or earning less than $35,000 per year, a full discount off the price of the program will be awarded upon written proof of hardship. Attorneys earning between $35,000 and $50,000 per year will receive a 50% discount off the price of the program. Any attorney working in the public service sector also qualifies for a special price. If you have further questions regarding the hardship policy or seek additional information, please contact Bloomberg BNA customer service at 800-372-1033 and ask to speak to the CLE Accreditations Coordinator, or email us at

For more information about Mandatory or Minimum Continuing Legal Education (MCLE) requirements, visit the American Bar Association website at

*Bloomberg BNA is an accredited provider in New York for experienced attorneys only.