Health Care Fraud and Abuse: Reflections After the Last Class of the Semester at BU Law School

Author: Robert M. Thomas, Jr., Erica Blachman Hitchings,

Whistleblower Law Collaborative partners Bob Thomas and Erica Blachman Hitchings recently called it a wrap in their BU School of Law Health Care Fraud and Abuse seminar.

The Course

Over thirteen two-hour sessions this fall, nine second- and third-year students participated in a deep dive into Health Care Fraud and Abuse. The course covered the substantive law, regulations, and judicial opinions of this heavily-regulated industry. It also emphasized the practical ways in which lawyers operate. Four of the sessions featured guest speakers including compliance officers, defense lawyers, prosecutors, and whistleblowers. Each shed light on how these laws impact the way they work and live.

The Final Class

The final session started with the always entertaining and revealing Jeopardy Game, which you too can take a crack at here. This game is useful both as entertainment and as a study guide.  It shows how the course blends doctrinal substance with “Tricks of the Trade.”

The students also shared what they got out of the course with some thoughtful insights. Here’s a sampling:

• One student said she found it revealing that it is both easy to run afoul of fraud and abuse laws, but also quite easy to get away with intentionally violating them. Both points are true and somewhat troublesome. The ensuing discussion touched on the fact that there are many ways to find oneself in hot water, particularly in professions where there is no training in these laws. Paradoxically, the sheer volume of fraud and challenges in attacking it make “getting away with it” easier than one might expect.
• One student said that, after being deluged with cases showing myriad ways actors in the health care space game the system, she found the final readings more hopeful. These readings tackled the question of how to improve the system. The class discussed that one of the “occupational hazards” of working in the fraud and abuse sector is that one tends to focus on things that have broken down, not things that are working well. It takes some perspective to realize that in a health care economy hard-wired for profit at every level and thus full of examples of bad apples, many actors are compliant and want to stay compliant.
• One student said he was surprised to learn how interesting and nuanced the False Claims Act is. He said that he expected it to be a law simply stating “thou shall not submit false claims.” He was fascinated to see how intricate and cross-cutting it is, particularly the way it intersects with other laws such as the Anti-Kickback Statute and Food Drug and Cosmetic Act. This echoes the experience of WLC co-founder Suzanne Durrell, who has confessed to falling in love with a statute.

The Value and Joy of Teaching

This was Bob’s tenth time teaching this course, and Erica’s first. The dual energy was a new and positive twist, but the takeaways are the same. First, this topic is far more interesting than even seasoned practitioners could imagine. Second, teaching is a wonderful way to stay connected to open and eager minds and up to date on the latest developments in the law. And third, saying goodbye to students one has come to know and respect is always difficult. That said, Bob and Erica know the students will be ready to hit the ground running when they step out of school; they look forward to watching them succeed!