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Fraud, Healthcare, COVID-19 and the False Claims Act

Catherine Short speaks with Shauna Itri, Partner at Seeger Weiss LLP on the topic of “Fraud, Healthcare, COVID-19 and the False Claims Act.” A whistleblower or qui tam action can provide financial rewards to individuals who have information that a company/individual has committed fraud. The primary statutes under which this relief may be sought are the federal and state False Claims Acts (“FCAs”). In addition to the FCAs, there are other statutes which apply to tax fraud, securities fraud, and in California, fraud on private insurance companies. This episode will provide an overview of the False Claims Acts, the knowledge and skills to be able to recognize a potential whistleblower case, and understand the unique procedures utilized in filing whistleblower cases/tips. We will also delve into recent trends in cases brought (or that could be brought) under the False Claims Act including cases involving mined data and potential fraud related to COVID-19.

What you need to know about the No Surprises Act

Enacted in late 2020 as part of the Consolidated Appropriations Act of 2021 with an effective date of Jan. 1, 2022, the No Surprises Act (NSA) underscores its primary purpose is to protect patients from surprise medical bills when receiving certain services from – emergency services, non-emergency services from nonparticipating providers at participating facilities, and air ambulance service from nonparticipating providers. (86 Fed. Reg. 36872 (Jul. 13, 2021)).

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