Category: General

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...

Welcome to the New Corruption Crime & Compliance

Happy New Year!!!  Welcome to 2013 and the New Corruption, Crime & Compliance Site.  I hope you enjoy the new site.  I am glad to bring the website to the LeClairRyan sitemaster. Some of the new features on the website include: A preview window at the top recapping entries from the previous week. A new easier to read format with previews of latest posts. An...

Internal Investigations: Making a Decision (IV of IV)

Internal Investigations: Making a Decision (IV of IV)

“When a decision has to be made, make it. There is no totally right time for anything.” – General George Patton Companies need to be careful when resolving an internal investigation.  Assuming the results of an internal investigation are only used internally and not reported to a government agency, companies have to act transparently and with care.  During the internal investigation confidentiality is important to...

Routine Internal Investigations and Interviews (Part III of IV)

Routine Internal Investigations and Interviews (Part III of IV)

Interviews are the critical part of every internal investigation.  Before conducting any interviews, it is important for the investigator to know as much as possible about the events under investigation.  Such knowledge can come from documents, emails, financial audits, forensic studies and any other information.  Practitioners know that interviews should be conducted in reverse order – meaning from least important to most important.  The more...

“Routine” Internal Investigations: Initial Phase (Part II of IV)

“Routine” Internal Investigations: Initial Phase (Part II of IV)

Decisions by the Supreme Court provide compelling reasons for employers to perform investigations.  A good investigation can protect your organization, while a bad one can become an employee relations fiasco.  If companies follow the proper process, companies should end up making the “right” decision. Typically, “routine” internal investigations focus on day-to-day matters: Accounting fraud Theft of physical assets Unauthorized access to data (manipulation or sale)...

Internal Investigation Procedures (Part I of IV)

Internal Investigation Procedures (Part I of IV)

This is the first of four postings on internal investigations.  The focus of these postings is not the high-profile internal investigations which are regularly disclosed to the SEC or reported in the press.  Instead, I am focusing on “routine” or day-to-day internal investigations which are conducted to handle a variety of issues.  The art of day-to-day internal investigations has been ignored in favor of media...