Author Description

The 2011 Cumulative Supplement includes new material on: Cases that impose criminal liability or other sanctions on individuals convicted of health care fraud and abuse violations Changes to the False Claims Act, including revisions to the public disclosure jurisdictional bar, overpayment reporting requirements, whistleblower retaliation provisions, and the anti-kickback statute The expansion of Part D fraud and abuse enforcement, including the 2012 Final Rule on changes to both the Medicare Advantage and Medicare Prescription Drug Benefit programs, and new CMS initiatives, including guidance on Part D Plan Sponsors and audits of sponsor operations, particularly related to compliance programs Fraud enforcement, especially concerning abuse affecting providers, drug and device manufacturers, and payors, in contexts including clinical research, securities fraud, off-label marketing, kyphoplasty, and kickbacks Developments in the Stark law, including coverage of the new PPACA provisions and implementing regulations; new disclosure requirements and modifications to the whole hospital exception; new cases interpreting various aspects of the law; and interactions between the Stark law and ACOs.