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University of Iowa News Release

March 17, 2005

Law Course Focuses On Fighting Health Care Fraud

A University of Iowa College of Law class is training law students to fight health care fraud and abuse, a problem plaguing America's health care industry and one of the reasons for rising health care costs.

"Health care costs are skyrocketing," said Professor Josephine Gittler, a health care law expert who is teaching the course. "Health care spending accounts for nearly 15 percent of America's gross domestic product and that number is going up. It has been estimated that 10 percent of the $1.7 trillion Americans spend on health care each year is lost to fraud and abuse by health care providers, drug companies and other health care businesses."

Gittler said the course provides an introduction to the application of fraud and abuse laws to health care providers. Ultimately the cost of much of this abuse is paid for by taxpayers because government programs like Medicare and Medicaid pay an increasing share of American's health care expenses. Gittler credits Iowa Senator Charles Grassley for the Federal False Claims Act, the main weapon prosecutors use to combat health care fraud.

Nationally recognized experts on health care fraud are participating in the course with Gittler. The course is being co-taught by Tony Patterson, a prominent health care attorney from Dallas, Texas, who is chair of the American Bar Association's Health Law Section. A guest lecturer is James Sheehan, an associate United States attorney in Philadelphia and one of the Department of Justice's most successful prosecutors of fraud and abuse causes.

Gittler said health care fraud and abuse takes many forms, such as billing for lab tests that were not medically necessary, performing unnecessary medical procedures and overstating the health care provided to get higher reimbursements from the government or insurance companies. To demonstrate the scope of the problem, she points to recent judgments against TAP Pharmaceutical and AstraZenica Pharmaceuticals, which gave free samples of drugs to doctors who then billed Medicare for the costs; Tenet Healthcare, the owner of a hospital in California that allegedly bilked Medicare by charging it for thousands of unnecessary heart procedures performed on healthy patients; and First American Health Care of Georgia, a home health care company that billed Medicare for millions of dollars of unrelated expenses, including the personal expenses of the company's senior management. But the largest recent judgments have been paid by HCA, a hospital ownership group that has in the past five years paid more than $1.3 billion in fines.

Gittler said the health care system is ripe for fraud and abuse because it's so large and the delivery of and payment for health care are enormously complex. In order to prevent and control fraud and abuse the health care industry is heavily regulated by the government. As a result, health care law has become something of a growth industry within the legal profession. The health care industry hires many attorneys to insure compliance with fraud and abuse laws and regulations, and governmental agencies hire many attorneys to investigate and prosecute violations.

Gittler said the course is for law students and is being taught as in intersession course during the law school's spring break from March 14-19. Gittler said the course will be offered regularly.

EDITOR'S NOTE: Media representatives are invited to interview Profesor Gittler, Mr. Patterson and Mr. Sheehan. Sheehan will be lecturing during the classes on Saturday, March 19. Please contact Tom Snee to make arrangements.

STORY SOURCE: University of Iowa News Service, 300 Plaza Centre One, Suite 371, Iowa City, Iowa 52242-2500.

MEDIA CONTACT: Tom Snee, 319-384-0010, tom-snee@uiowa.edu.