Category: General

Hospitals Need to Focus on Data Privacy and Security

To restate the obvious, hospitals operate in a risky environment.  They face a variety of risks and a blanket of government regulations.  You have to admire the Chief Compliance Officer at a hospital.  They learn to live with these risks. In response to our new Internet age, the government has prioritized protection of privacy and consumer data. In the healthcare industry, this is not a...

The Cutting Edge of Anti-Corruption Compliance: Proactive Audits

The FCPA world is fast-becoming the leader in new compliance strategies.  The Justice Department and the SEC have embraced the requirement for conducting “proactive audits.” Recent settlements have included new compliance program requirements for a company to conduct proactive audits of high-risk areas.  It is a new and growing area for anti-corruption compliance. The concept of a “proactive” audit, however, is nothing new.  The strategy...

Insider Trading Enforcement and Deterrence

It is hard to know whether the government’s aggressive enforcement of insider trading laws deters criminals from violating securities laws. One key factor in this equation is the risk of getting caught. The Obama Administration can certainly point to an increase in enforcement – civil and criminal.  Judges have been handing out stiff sentences for insider trading. The 1980s were the so-called glory years of...

The Attorney-Client Privilege and Compliance

Many people ask “Why do I need a lawyer?”  Candidly, sometimes it is hard to answer that question.  (I often ask myself the same question). On a more “sophomoric” note, I often think of the attorney-client privilege as the “cone of silence” often used by Agent 86, Maxwell Smart, when talking to the Chief.  Hopefully, the attorney-client privilege works a little better than the old...

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

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...