Health Care Fraud Enforcement - The Final Frontier

This panel will examine the state of health care fraud investigations and prosecutions over the past year. As baby boomers swell the ranks and costs of Medicare beneficiaries, health care fraud cases remain the predominant area for False Claims Act civil actions and are increasingly being pursued criminally, often in parallel investigations. Panel members will discuss the implications of recent DOJ policy announcements—including the May 2019 guidance regarding cooperation credit in FCA investigations, which has impacted strategic decisions to be made by defendants, and the implementation of the 2018 Granston Memo and the related dispute about the proper standard for DOJ dismissal. The panel will also discuss key recent court opinions in healthcare fraud, as well as the government enforcement approach to the opioid epidemic and its continued focus on kickback violations, implied false certification and Escobar materiality, and the use of sampling and extrapolation to drive massive damage calculations.

Jack W. Selden (Moderator), Bradley Arant Boult Cummings LLP
J. Thomas Clarkson, U.S. Attorney's Office, Southern District of Georgia
Kathleen McDermott, Morgan Lewis
Kirk Ogrosky, Arnold & Porter
Jason D. Popp, Alston & Bird, LLP