In Case You Missed It: Guidance on Health Care Fraud Enforcement and Compliance

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The Houston Bar Association and the University of Houston Law Center Health Law & Policy Institute partnered to host the “Guidance on Health Care Fraud Enforcement and Compliance - A Conversation with HHS Counsel and Other Experts” event in Houston on December 10, 2019.

The event brought together industry leaders, regulators, and Seyfarth attorneys for a timely conversation on key legal developments in 2019 in the area of health care regulation.

Seyfarth Health Care group co-lead Jesse Coleman moderated the panel featuring an impressive roster of health care experts:

  • William Chang, Deputy General Counsel, U.S. Department of Health and Human Services
  • Robert McStay, Senior Associate General Counsel, Memorial Hermann Health System
  • Mark Easterly, Vice President for Legal Services, Houston Methodist
  • Chris DeMeo, Partner at Seyfarth

The panelists, along with our attendees, shared their unique perspectives and highlighted the regulatory and legal trends affecting this industry. Attendees included a mix of general counsel for health systems throughout Houston, key regulatory private practitioners, and executive leadership of numerous companies in the industry.

Discussion topics included:

  • Notice of proposed rulemaking regarding Stark and Anti-Kickback regulations and the move towards value-based medicine.
  • Case law developments (including the Allina and Polansky cases) and HHS’ Cleary Memo addressing notice-and-comment requirements for sub-regulatory guidance.
  • The Granston Memo, the DOJ’s increased motions to dismiss meritless False Claims Act cases, and the circuit split regarding the courts’ standard of review of such motions.
  • The Justice Manual sections addressing credit for cooperation in FCA investigations.

Key takeaways:

  • The proposed rulemaking, the Granston Memo, the Cleary Memo, and the case developments are all steps in the right direction towards value-based health care, cost transparency, and due process in governing law; but much yet needs to be done.
  • These issues are not going away; we will likely be discussing them all again next year, with the key difference being that we will be discussing final rules instead of proposed rules.

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