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Private Enforcement of Healthcare Fraud & Abuse
by:Nathan Fish, LL.M, J.D., B.S.
Objective: This presentation will give the listener a comprehensive overview of the enforcement of healthcare fraud and abuse.
Overview of Enforcement agencies
Overview of Federal and State fraud and abuse statutes
Private enforcement of fraud and abuse laws
Nathan Fish, LL.M, J.D., B.S.
Nathan Fish counsels health care clients on a wide range of regulatory issues, including fraud and abuse, marketing, Medicare/Medicaid enrollment and reimbursement, and licensure. Nathan also has wide-ranging experience with health care transactions, internal investigations and compliance reviews, and government enforcement actions, investigations, and audits.
Somer Hayes focuses her practice on health care law, including regulatory, transactional, administrative and litigation matters.
Somer has assisted in representing hospitals, physicians, physician groups, and other health care industry clients in a variety of transactional matters, including the formation of joint ventures, the purchase of facilities and other assets, employment agreements, coverage contracts, business associate agreements, medical office leases, and management services agreements. She has knowledge of and experience with federal and state regulation of the health care industry, assisting in advising clients as they navigate issues related to the Stark law, the federal anti-kickback statute, HIPAA, HITECH, and health care reform legislation. She has also assisted in representing clients in licensing structure via state regulatory authorities. Somer has assisted clients in preventing and responding to investigations, including establishing and maintaining compliance programs. She has also assisted in representing physicians and nurses in professional liability matters, including malpractice defense and licensing board investigations.
Prior to entering private practice, Somer was a registered nurse in various hospital and outpatient settings. She has broad experience with both the clinical elements of the health care industry as well as the practical business elements of providing those clinical services in a highly-regulated environment.
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help healthcare providers and their staff maintain focus on patient care
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