Healthcare fraud continues to plague providers, managed care, and drug companies.  $5.7 billion of the $6.8 billion recovered by DOJ was generated from the healthcare industry.  There is a bottomless pit of possible targets.  DOJ’s only constraint is its resources assigned to prosecute FCA cases in the healthcare industry.  DOJ focused on three major areas: Managed Care, Prescription Drugs, and Medically Unnecessary Care.  In Managed...

The Justice Department has increased False Claims Act prosecutions, reflecting a continued focus on healthcare fraud and a new initiative on trade fraud.  DOJ announced the largest annual recovery figure in the FCA’s history — $6.8 billion in settlements and recoveries.  FCA whistleblowers filed a record number of new cases — 1,297 lawsuits and the government initiated 401 investigations.  Since 1986, DOJ has recovered a...

Here are the five primary risk areas when a company uses AI in a supportive or assistance-based role as opposed to an algorithmic-based use case. 1. Data Protection and Cybersecurity: Internal AI use cases may involve chatbots, drafting of documents, emails, and other deliverables (e.g. slide decks).  To the extent employees incorporate sensitive data (e.g. confidential, personal or regulated data) into AI vendor tools, such...

From my perspective, hopefully a reasonable one, there is a little too much AI-Risk Hype.  Not to belittle the experts or ignore potential risk concerns but this is getting a little carried away.  The compliance industry appears to be taken over by AI-this and AI-that.  Third party risk bleeds into major AI risks, corporate governance needs to incorporate AI risks, and policies and procedures have...

The Justice Department knows how to use the False Claims Act — it is the primary tool against fraudsters in the healthcare industry, and going back even further, it was used against the defense industry in the 1980s and 1990s.  DOJ has turned the tool towards another angle and this portends a significant trend.  DOJ is opening up a new front in the trade enforcement...

Typically, I enjoy the New Year (notwithstanding Larry David’s rule of no New Year wishes past 15 days of the New Year).  It is important to look back, assess and identify trends; after all, what better marker than annual reviews. The most significant compliance and enforcement issue remains trade enforcement — sanctions and export controls.  In the second posting, I want to focus on the...

On January 7, 2026, the U.S. Department of Commerce’s Bureau of Industry and Security (“BIS”) issued an Order resolving an administrative enforcement action against Exyte Management GmbH, a Germany-based company headquartered in Stuttgart, in connection with alleged violations of the Export Administration Regulations (“EAR”). The action arose from conduct occurring between March 2021 and March 2022 and involved in-country transfers of items subject to the...