Webinar: Estimating Damages in FCA Litigation

Damage estimation in False Claims Act Litigation can proceed under alternative interpretations.  On one hand, fraudulent claims can be interpreted as “tainted” implying damages are equal to the entire cost of the claim; alternatively, damages can also be viewed as the net loss the government faced – accounting for the idea that there was some benefit in the provided services.  This session will expound on these viewpoints, discuss the economics of estimating damages in FCA cases, and review recent FCA happenings.

Sponsored by Cornerstone Research

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About the Presenters:

Maria Salgado, Vice President, Cornerstone Research (Moderator)

Maria Salgado conducts economic analyses for complex business litigation matters, particularly those involving pharmaceuticals and healthcare. Her experience covers intellectual property, antitrust, reimbursement disputes, and consumer fraud matters. Dr. Salgado works with attorneys on all phases of the litigation process and has prepared experts for deposition and trial. Who’s Who Legal has recognized her as a future leader in the competition field and “an authority on the pharmaceuticals space.” Dr. Salgado has extensive experience analyzing sampling, liability, and damages issues in reimbursement disputes. She has assessed fair market value in relation to alleged kickbacks to physicians; analyzed the sampling and extrapolation of claims; evaluated reasonable rates for out-of-network services; and consulted on False Claims Act matters. Dr. Salgado has extensive expertise with health insurance issues, including Medicare Fee-for-Service, Medicare Advantage, Medicaid, commercial insurance, healthcare exchanges, and the Affordable Care Act. Prior to joining Cornerstone Research, Dr. Salgado worked at the World Bank in Washington, DC, and at Galanto Consulting in Rio de Janeiro, Brazil.

Andrew A. Caffrey III, Assistant U.S. Attorney, U.S. Attorney’s Office for the District of New Jersey

Andrew Caffrey is an Assistant U.S. Attorney in the Health Care Fraud Unit based in Newark, New Jersey. He brings affirmative civil enforcement actions involving fraud and abuse in the health care industry, including illegal kickbacks, the sale of misbranded drugs, and fraudulent billing schemes. He is also the civil Health Care Fraud Coordinator for his office, with responsibilities for monitoring his office’s docket of whistleblower litigation, training new AUSAs, and serving as a liaison with Main Justice and other U.S. Attorney’s Offices. Before joining the U.S. Attorney’s Office in New Jersey, Mr. Caffrey had been in private practice in Boston for nearly ten years, representing clients in white collar defense as well as in a wide range of civil litigation. He also taught a January term course for a number of years at Harvard Law School.

Dan Kessler, Professor of Political Economy, Stanford University

Daniel Kessler is a professor at Stanford Graduate School of Business, a senior fellow at Stanford’s Hoover Institution, a professor at Stanford Law School, and a Research Associate at the National Bureau of Economic Research. His research interests include empirical studies in antitrust law, law and economics, and the economics of health care. He holds a PhD in economics from M.I.T. and a law degree from Stanford. He has won awards for his advising and research from Stanford, the National Institute of Health Care Management Foundation, and the International Health Economics Association. He has received grants from the National Institute of Health, the National Science Foundation, and the California Health Care Foundation. He has served as a consultant to corporations, foundations, and the governments of the United States and Canada. He has taught courses in health economics, public policy, and antitrust law at Stanford and the Wharton School at the University of Pennsylvania. He has published numerous papers in economics journals and law reviews. He has also written extensively on health care reform for the Wall Street Journal and Health Affairs. His new book, Healthy, Wealthy, and Wise: Five Steps to a Better Health Care System (with John Cogan and R. Glenn Hubbard), outlines how market-based health care reform in the U.S. can help fix our system’s current problems. Currently, he is investigating how to use medical claims data to identify the types of health care providers that are likely to commit Medicare fraud and abuse.

David C. Tolley, Partner, Latham & Watkins

David Tolley, Chair of the Boston Litigation & Trial Department, represents clients in high-stakes government investigations and litigation, especially clients in the healthcare and life sciences industries. Mr. Tolley advises and defends healthcare and life sciences organizations, in addition to organizations in other heavily regulated industries, including regional and national hospital systems, health insurers, medical device manufacturers, pharmaceutical companies, and other organizations, in a variety of investigative, litigation, regulatory, and compliance matters. Mr. Tolley has represented numerous healthcare and life sciences organizations, in addition to organizations and companies from other heavily regulated industries, under investigation by state and federal authorities, and he regularly conducts internal investigations. Mr. Tolley has also assisted in developing comprehensive organizational compliance programs. Prior to joining the firm, Mr. Tolley practiced at another leading firm in Boston.

Registration

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No refunds will be made for cancellations received after the close of business on August 5, 2020. No-shows will be billed. Substitutions may be made at any time upon notification. Please contact Ariel White at awhite@fedbar.org with cancellation and/or substitution requests.

CLE

Please note that CLE credit is not offered for this webinar.

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