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Prosecuting and Defending Health Care Fraud Cases, Second Edition, with 2013 Cumulative Supplement


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2010/1,216 pp. Hardcover/Order #9273P

Written by two experienced litigators, Prosecuting and Defending Health Care Fraud Cases, Second Edition is the only book of its kind that covers the subject of health care fraud from two distinct angles: the applicable law and the federal criminal process for health care fraud cases. This comprehensive book is invaluable for its analysis of trials conducted in a variety of cases, with chapters structured to match the process as it actually takes place during the investigation, after charges are brought, and through sentencing. This treatise presents possible charges, investigative tools, proven trial strategies for both prosecution and defense, considerations for settlement of a prosecution or civil suit, and factors applicable in sentencing.

Lawyers and litigators will appreciate its thorough review of all aspects of the federal health care law; analysis of changes to the anti-kickback statute; discussion of transparency requirements for drug and device companies; overview of new subpoena authorities, and new rules on exclusion and penalties; and discussion of other important and timely health care fraud issues.

2013/646 pp. Softcover/ISBN 978-1-61746-093-7/Order #2273

The  2013 Cumulative Supplement expands the scope of the book and provides new updates, including: 

  • New regulations on Medicare transparency reports that address obligations under 42 U.S.C. §1320a-7h that narrow the unambiguous language in the statute regarding the scope of “applicable manufacturers” who are required to report to the Secretary
  • Analysis of decisions reviewing whether the government may prosecute truthful, non-misleading statements about a product that are “off-label” as violations of the Food, Drug, and Cosmetic Act
  • Ongoing review of developments in sentencing in health care fraud prosecutions
  • Coverage of all significant new Office of Inspector General (OIG) Advisory Opinions issued under the federal anti-kickback statute, including Advisory Opinion Nos. 12-09 on “swapping” arrangements and 12-02 on the relationship between a website and providers that offers discount coupons to patients for certain services and sells advertising to the providers
  • Detailed analysis of trends in health care fraud settlements, in addition to updates to the compilation of virtually all settlements of at least $1 million 

Main Volume Information  

About the Authors
Michael K. Loucks 
is the former Acting U.S. Attorney and First Assistant U.S. Attorney for the District of Massachusetts. He is now a litigation partner with Skadden Arps, LLP, Boston, MA.

Carol C. Lam is the former U.S. Attorney for the Southern District of California.
Pharmaceutical Industry Blog on Michael Loucks’ Federal Career

An Article by Michael K. Loucks in Business Week magazine  

Supplement Information

By Michael K. Loucks