Jan 21 • 38M

Attorney Ms. Jayne Conroy Discusses Prosecuting Healthcare Fraud in Part Via Use of Criminal Statutes (January 19th)

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Appears in this episode

David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
Episode details

US healthcare fraud remains pervasive.  For example, this past November Pro Publica and The New Yorker published, “How the Visionary Hospice Movement Became a For-Profit Hustle."  (The article may remind readers of Eric Hoffer’s comment, “every great cause begins as a movement, becomes a business, and eventually degenerates into a racket.")  The National Health Care Anti-Fraud Association estimates healthcare fraud across the entire industry can be as high as 10% of total annual healthcare spending, or approximately $400 billion.     

During this 37 minute conversation, Ms. Conroy begins by describing decisions her firm recently achieved in civil court against Walgreens, CVS and Walmart related to opioid prescribing and discusses criminal convictions against Purdue Pharma related to Oxycontin that, however, did not include prison sentences.  She discusses the use of criminal codes, for example the Racketeer Influenced and Corrupt Organizations (RICO), or how they can come into play in cases of alleged healthcare fraud, and RICO's utility for civil litigation attorneys.  Ms. Conroy next discusses fraudulent healthcare billing largely in context of civil litigators' ability to publicly expose related corporate information, she discusses prosecution of fraudulent pharmaceutical marketing, and concludes with comments regarding healthcare fraud can be, or is being, better policed.            

Ms. Jayne Conroy is a named shareholder at Simmons Hanly and Conroy overseeing practice areas in the firm's Complex Litigation Department that addresses addresses mass torts, class actions, product liability, pharmaceutical and sexual abuse litigation.  She serves or has served on dozens of court appointed leadership committees in complex legal actions of national scope.  In 2022, Law360 named her a Titan of the Plaintiffs’ Bar.  Previous honors include induction into the National Trial Lawyers Association’s Trial Lawyer Hall of Fame, election as a member of the exclusive American Law Institute, recognition as an Elite Women of the Plaintiffs Bar Winner by The National Law Journal, and the American Association for Justice’s Lifetime Achievement Award.  Ms. Conroy was graduated from Dartmouth College and the New England School of Law. 

The ProPublic hospice article is at: https://www.propublica.org/article/hospice-healthcare-aseracare-medicare.

The Lown Institute 's 2023 Shkreli awards noted in the introduction is at: https://lowninstitute.org/projects/shkreli-awards/.

Kaiser Health News' "The System Feds Rely on to Stop Repeat Health Fraud Is Broken," is at: