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

Panel (L-R) - Jesse Coleman, Seyfarth; William Chang, U.S. Department of Health and Human Services; Chris DeMeo, Seyfarth; Rob McStay, Memorial Hermann; Mark Easterly, Houston Methodist 

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.

For more information, please reach out to Jesse Coleman.