Understanding the False Claims Act (FCA) and Ongoing Government Enforcement and Compliance Efforts

April 30, 2014 2:45pm

Heidi A. Sorensen
Of Counsel
Foley & Lardner LLP

Wendy C. Goldstein
Cooley LLP

Kirsten Mayer
Ropes & Gray LLP (Boston, MA)

​False Claims Act (FCA) Cases – A Year in Review
• Insulating yourself from FCA liability
• What to do when no formal rule is in place
• Drafting a letter to the agency
• Dealing with gray areas complicated by the fact that there is currently no guidance
– Bundling
– 5I
– Reconciling AMPs
• What should you be doing with the fact that you are within the period of restating AMPs after health care reform kicked in
• Minimizing exposure when making reasonable assumptions

The Enforcement Roles of OIG and Other Agencies
• Understanding the current environment for compliance and enforcement related to pricing issues
• Identifying compliance guidance for pricing issues
• Analyzing enforcement trends
• Anatomy of a government investigation
• Roles of CMS, OIG and DOJ
• Responding to government investigations
• Collateral consequences of investigations
• State enforcement issues

4:15 Conference Concludes