New book on fraud and abuse laws and regulations affecting health care industry published

BNA Books, a division of specialized news and information publisher BNA, announced today the publication of the 2009 Cumulative Supplement to Health Care Fraud and Abuse: Practical Perspectives, Second Edition. The main volume and its supplement are published in conjunction with the American Bar Association (ABA) Health Law Section.

Government enforcement in perceived instances of fraud and abuse in the health care industry continues to accelerate and expand into new areas -- often leading to record-breaking settlements. Long-accepted business practices may suddenly be investigated as potential "crimes." Gray areas in the law are numerous, making it difficult to know how to proceed safely.

Health Care Fraud and Abuse: Practical Perspectives, Second Edition details the fraud and abuse laws and regulations affecting the health care industry and gives you the practical guidance you need to protect your clients. This treatise offers seasoned practitioners, as well as those new to health care law, assistance in structuring acceptable business arrangements, avoiding statutory and regulatory pitfalls, defending clients, implementing effective corporate compliance programs, and more.

The 2009 Cumulative Supplement contains extensive updates, including:

• A new chapter on fraud and abuse in the clinical trial context, covering financial misconduct in clinical research, misconduct in human subject protection, and research misconduct, describing applicable laws, regulations, and other guidance and case law developments, as well as recommendations for compliance
• Expanded information on hospital-physician relationships, including joint ventures such as whole hospital ventures, ambulatory surgical center (ASC) ventures, under arrangements relationships, physician-hospital organizations, service line leases, acquisition of physician practices and clinical co-management, as well as economic and other credentialing issues such as gainsharing
• Detailed analyses of the changes to the Stark regulations implemented in the 2009 Inpatient Prospective Payment System (IPPS) regulations, including the modifications to the critical definition of "entity" so as to preclude most "under arrangements" relationships with physician-owned companies, restrictions on the ability to use per click or percentage compensation in certain cases, the newly defined concept of the "period of disallowance," and the changes to the "stand in the shoes" concept, among others
• Discussion of Medicare Part D fraud and abuse and the regulations issued to implement the Medicare Improvements for Patients and Providers Act (MIPPA), particularly with regard to marketing and sales agent compensation, payment timelines for pharmacy claims, several key definitions including "incurred costs" and "negotiated prices," as well as descriptions of recent enforcement initiatives

Practitioners can turn to this treatise for guidance and invaluable insight into a critical area of the law affecting the health care industry.

SOURCE BNA Books