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Spring 2025 Reading Group

Corporate Fraud, Abuse, and Other Health Care Regulatory Schemes

Prerequisites: None

Exam Type: No Exam

This reading group will provide an overview of key issues in health care regulatory compliance and enforcement. We will discuss the origins and evolution of several laws that govern health care activity, compliance risks posed and common forms of abuse, approaches to investigation and enforcement, and intersections between the law and prevailing industry trends. Health care is one of the largest and most heavily regulated industries with growing demand for specialized legal expertise. A core goal of the reading group will be to build students’ expertise on foundational issues and prepare them for further exploration of the field.

The reading group will open with readings about the health system broadly and the range of stakeholders with an interest in how it operates. It will then turn to the first core area of compliance: fraud and abuse in federal health care programs. We will focus on three specific laws (the Anti-Kickback Statute, Stark Law, and the Civil Monetary Penalties Law) with unique implications for health care. Next, the group will look at health care data privacy laws, considering opportunities and challenges in the ever-evolving and complex web of information sharing activities that health care undertakes. After that, the seminar will focus on emerging areas of interest to regulators as pertaining to corporate compliance risks, including private equity investment in health care and the use of artificial intelligence in health care. Finally, we will learn about the elements of an effective compliance program alongside strategies to promote a culture of compliance within an organization.

Note: This reading group will meet on the following dates: TBD.