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The Fraud and Abuse Practice Group provides issue summaries and brief analysis of relevant judicial, administrative, and settlement decisions as well as regulatory developments regarding enforcement efforts and compliance responses; provides a resource to members facing enforcement initiatives and/or designing compliance strategies.
 
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Summaries of the Office of Inspector General (OIG) Advisory Opinions are provided by the Advisory Opinions Task Force of the Fraud and Abuse Practice Group. The Task Force aids Practice Group members in keeping abreast of new Advisory Opinions. For each new opinion issued by the OIG, a summary is released via an email alert and posted on several Practice Groups' websites.

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Member Briefings, prepared by members of Practice Groups, are a useful practice tool to facilitate your understanding of the most recent health law issues and to assist you and your clients with implementing those issues.

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Executive Summaries, prepared by members of Practice Groups, are a useful practice tool to facilitate your understanding of the most recent health law issues as they develop.

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Newsletters offer articles on the most recent issues facing health law attorneys within their practice area. They also provide news of recent Practice Group events and highlight opportunities to get involved in the Association.

Interested in writing an article? Please submit your article proposal to the Practice Groups staff including the title/topic and a short summary, and indicate which Practice Group(s) you would like to submit it to.

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Health Care Real Estate Lease - Published on January 16, 2015
This Toolkit is designed to assist counsel in structuring legally compliant hospital-physician real estate leases. It places particular focus on the fair market value and commercial reasonableness standards and the technical requirements for leases under the applicable safe harbors and exceptions to the Anti-Kickback Statute and Stark Law. The Toolkit is structured as a compilation of the relevant statutes, implementing regulations, interpretative agency commentary, advisory opinions, and case law materials. The Toolkit also provides general considerations when engaging a third-party valuation consultant to document compliance with the fair market value and commercial reasonableness standards.

Stark Law - Updated on November 1, 2013
This Toolkit is intended to provide Fraud PG members with a one-stop resource for all guidance under the Stark Law. The Toolkit includes the relevant statutes, regulations, and Federal Register preambles for the various proposed, interim, and final rules. Adding additional value to the practitioner, the Toolkit provides direct links to the various Stark Law exceptions within each of the Federal Register publications, making it easier to quickly access commentary on specific exceptions. The Toolkit also contains informal guidance and publications issued by AHLA for its members.

 
If you have any comments about this toolkit or suggestions on potential toolkits, please email the Practice Groups staff

 

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​This is a members-only, web-based reference tool that features substantive practice development information focusing on the False Claims Act and other government matters. Designed to bring timely, practice-oriented data to Fraud and Abuse Practice Group members, categories of information on this site range from current negotiating issues with the Department of Justice on False Claims Act cases to seminal cases. The Practice Corner provides practice points and other information and is not restricted to defense perspectives. The Practice Corner presents practice information that is helpful for all practice areas.

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Upcoming:

Past:

Litigating a False Claims Act—Tips and Tactics from the Trenches
Part V: Select Trial Issues, Closing Arguments, Post-Trial Motions, and Appeals
January 16, 2015 12:00 PM-1:30 PM Eastern

Upcoming:

Past:

Upcoming:

June 29, 2015 12:30 PM-1:45 PM Eastern
June 30, 2015 12:30 PM-1:45 PM Eastern
July 1, 2015 12:30 PM-1:45 PM Eastern

Past:

April 16, 2015 12:00 PM-1:15 PM Eastern
March 26, 2015 12:15 PM-1:35 PM Eastern
Institute on Medicare and Medicaid Payment Issues 2015
The Changing Landscape of Medicaid Coverage of Behavioral Health
March 25, 2015 12:20 PM-1:35 PM Eastern
Physicians and Hospitals Law Institute 2015
Practical Realities of Managing a Special Population
February 2, 2015 12:30 PM-1:45 PM Eastern
October 6, 2014 12:00 PM-1:30 PM Eastern

Task Forces

Task Forces are established for those health law topics that cross over several Practice Groups, and they provide collaborative, substantive resources for the benefit of the sponsoring Practice Groups' members.
Please note: You must be a member of the Fraud and Abuse Practice Group or one of the other sponsoring Practice Groups to receive benefits produced by these Task Forces.

  • Accountable Care Organization Task Force
    The Accountable Care Organization (ACO) Task Force monitors and evaluates the implementing statutes, regulations, cases, and secondary materials concerning ACOs. It provides written materials, webinars, and in-person educational activities to assist AHLA's members to implement ACOs and comply with ACO laws and rules. Since the ACO subject matter is so broad, and impacts the missions and interests of so many Practice Groups, the ACO Task Force is a multi-disciplinary/multi-group entity, and focuses its efforts on the production of a coherent and effective line of ACO-related educational materials using a variety of media and employing AHLA’s vast resources.
  • Behavioral Health Task Force
    The Behavioral Health (BH) Task Force is committed to advancing the understanding of laws impacting behavioral health, including the delivery of services to those living with mental illness, certain neurological conditions, substance use disorders or developmental disabilities, and reimbursement for such services. A complex framework of federal and state laws concerning privacy, information sharing and exchange, reimbursement, involuntary commitment, and other subjects provides unique challenges to health care providers and payers of behavioral health services. Scientific, legislative, and other developments, including health care reform, have presented new issues and opportunities in this area, including primary and behavioral health care integration initiatives, insurance coverage parity mandates, changes to Medicaid, and evolving public policy, to name a few. The BH Task Force monitors and evaluates these laws and developments through written materials, webinars, and in-person educational activities so that AHLA members are better equipped to advise clients on behavioral health topics. In addition, the work of the BH Task Force serves to raise awareness about how behavioral health laws influence health improvement efforts, and will include collaborative efforts with AHLA's Public Interest activities.

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    Kevin E. Raphael Vice Chair - Educational Programs Pietragallo Gordon Alfano Bosick & Raspanti LLP Philadelphia, PA (215) 320-6200 Email
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