Government enforcement in perceived instances of fraud and abuse in the health care industry continues to accelerate and expand into new areas-often leading to record-breaking settlements. Long-accepted business practices may suddenly be investigated as potential crimes, and gray areas in the law are numerous, making it difficult to know how to proceed safely. Health Care Fraud and Abuse: Practical Perspectives, Second Edition removes these uncertainties by outlining in detail the existing fraud and abuse laws and regulations-and offering the practical guidance practitioners need to protect their clients. This incomparable treatise offers seasoned attorneys, as well as those new to health care law, assistance in structuring acceptable business arrangements, avoiding statutory and regulatory pitfalls, defending clients, implementing effective corporate compliance programs, and more.

The 2012 Cumulative Supplement includes new material on:

• Legal developments applicable to Accountable Care Organizations (ACOs)
• Recent Stark Law developments, including the Tuomey case and new regulations relating to the whole hospital exception
• Key revisions to the Prescription Drug Benefit Manual, which provide guidance for Part D plan sponsors on how to implement their legally mandated comprehensive fraud and abuse programs
• New fraud and abuse developments in the area of clinical research
• Cases involving individual liability, particularly for directors, officers, and attorneys
• Several key new False Claims Act (FCA) cases, including one where another court recognized the difference between conditions of payment and conditions of participation for FCA purposes

2007/913 pp. Hardcover/Order #9066P

2012/ISBN 9781617460661/Order #2066