Category: General

2013 Enforcement Predictions

I always like to make predictions at the beginning of each year. My track record is plus and minus – sometimes on target, sometimes off-target. The biggest story in the last five years has been the rise of FCPA enforcement.  That story was eclipsed last year by the LIBOR scandal, AML/Sanctions enforcement, off-label marketing and criminal antitrust enforcement. Looking ahead, I do not expect much...

Audits, Audits and More Audits: Life in the Healthcare Industry

Healthcare suppliers and service providers live in a regulated world.  They are constantly under audit scrutiny.  Sometimes federal agencies (i.e private contractors) conduct the audits; other times state agencies conduct the audits.  The audits also vary in focus – claims, coding, privacy, and compliance.  The industry is constantly being audited.  For the next four years, healthcare companies can expect more audits, more risks and potentially...

EPA’s 2012 Enforcement Results – What Do They Mean?

I am happy to welcome back Tom Echikson, a partner in LeClairRyan’s Environmental Practice.  Tom’s bio is Here.  Shortly before the end of the year, EPA released its annual review of its civil and criminal enforcement results for the Fiscal Year 2012. See Here. Touting massive reductions in pollutant emissions and discharges as well as continued growth in civil and criminal penalties, EPA proclaimed that its “vigorous”...

The Person of the Year: The Whistleblower

In keeping with “tradition” (even if it is a one-year tradition), I like to start out the year looking back on the person of the year in 2012.  As we look through the developments of 2012, there is no question of the increasing importance – and protection of – whistleblowers is the most important trend from 2012. The government is always looking for new sources...

The Compliance Officer’s Crystal Ball

In the last five years, law firms and companies have aggressively added resources and capabilities to respond to increased FCPA enforcement and compliance needs.  Outside counsel have established practice areas dedicated primarily to FCPA enforcement and compliance issues. Five years from now is an eternity in the law enforcement and compliance fields.  What will the landscape look like? The most important change has been —...

Privatizing Health Insurance Companies for Anti-Fraud Enforcement

The federal government faces overwhelming challenges in trying to stem the tide of fraud in the health care system.  The problem is massive, and even with the increase in resources, and adoption of new tools to fight fraud, the government’s ability to reduce fraud is intractable. As the government’s role in healthcare continues to expand, fraudsters will continue to rip the system off.  Healthcare fraudsters...

Five Biggest FCPA Stories of 2012

One of my favorite “Seinfeld” episodes is when Jerry and George go to NBC to pitch their new television show which is about “nothing.”  There are some parallels to this posting.  FCPA settlements have dwindled during 2012. Even if I try to stretch some of the “important” cases such as Pfizer or Morgan Stanley, the fact is that FCPA enforcement has been slowing down.  There...

Fraud: Skilled Nursing Facilities and Nursing Homes

When it comes to healthcare fraud enforcement, the government knows how to target its resources.  It is estimated that at least 25 percent of all claims paid by Medicare are improper.  The government understands the implications of this figure and is ramping up yet again its efforts to fight fraud, prevent improper payments, and execute proactive prevention programs. The government also knows that the risk...

Banks Take It On the Chin

The end of the year was very tough for global banks.  For months significant enforcement actions were expected in the ongoing LIBOR manipulation probe and anti-money laundering and sanctions violations probes. This was not a year of FCPA enforcement – it was a year in which anti-money laundering, sanctions and LIBOR dominated the enforcement scene.  Banks have typically been “safe” from aggressive enforcement as long...

Data Privacy and Security Risks

If there is one issue which causes sleepless nights for business executives, it has to be data privacy and security.  While the laws are still being updated and drafted for new technologies and new threats, businesses need to address these issues now. Financial and healthcare companies already face legal requirements for protecting consumer data.  These have been in place for many years but federal and...