The Justice Department is continuing to use criminal enforcement as an important tool in the fight against healthcare fraud.  While the False Claims Act continues its important place in the fight against healthcare fraud, DOJ has used the criminal laws to prosecute players in significant fraud cases.  Five Individuals and Two Nursing Facilities, Pittsubrugh, PA: Five individuals and two for-profit skilled nursing facilities were indicted...

The Biden Administration warned the healthcare industry that it would aggressively prosecute fraud cases.  The Justice Department is executing on that promise and doing so with great success.  Week after week, we read about False Claims Act settlement with multi-million dollar penalties.  We barely hear much about healthcare compliance innovation and strategies — the industry is clearly treading water when it comes to proactive compliance...

We can all remember those instances of matchmaking in our past — we were confident our friends, if they met each other, would fall in love and even get married.  We believed that these two separate friends were “meant” for each other.  In the compliance context, I always expect Human Resources and Ethics and Compliance to be a perfect match.  They have so much in...

We live in a challenging time — yes, another profound grasp of the obvious. From my narrow perspective, there are two significant trends occurring at the same time — people are angry and more willing to express their anger and frustration in situations, while others appear to be embracing empathy, kindness and increased concern for others.  I know this sounds circular but hear me out....

Corporate culture is all the rage now, meaning it is an often used topic to signal commitment, sensitivity to issues of employee concern, and an awareness of governance trends.  In practice, as we all know, culture is not just about words — it is about action.  As the often repeated phrase goes — talk is cheap.  On the issue of culture, talk is not only...

As the leading hotline provider in the global market, NAVEX is in the unique position of collecting and analyzing employee reporting trends.  Each year, NAVEX issues an important report on current trends in employee reporting, whistleblowers, internal investigations and potential retaliation. NAVEX’s most recent report is interesting.  NAVEX’s database consisted of 1.37 million reports made in 2021 at organizations around the world.  Initially, NAVEX sets...

The proper balance in corporate prosecutions remains a tricky issue.  On the one hand, many argue that large fines and penalties against corporations are needed to deter criminal conduct, while others contend that shareholders bear the brunt of such penalties while corporate actors escape punishment.  In the most cynical sense, some argue that corporate fines are simply the cost of doing business. The pendulum swings...

The Justice Department announced the indictment in New York of Cary Yan, a Chinese entrepreneur, and Gina Zhou, his assistant, on FCPA and money laundering charges relating to a scheme to secure control of an atoll owned by the Republic of the Marshall Islands (RMI).  Yan and Zhou paid bribes to elected officials in the RMI in exchange for passing specific legislation.  Yan and Zhou...

The SEC has a long list of priorities and a full agenda.  One issue on its list was to address changes needed to the SEC’s whistleblower program. The SEC’s whistleblower program has been a success.  It was adopted as part of the Dodd-Frank Act in 2010.  Since then, it has resulted in significant enforcement actions and large payouts to whistleblowers.  Like any other program, the...

You know companies face a new and aggressive enforcement regime when shorthand terms, such as “greenwashing,” are adopted prior to the implementation of comprehensive regulations governing disclosure of climate change issues and cyber-incidents. When these new regulations are adopted, companies will have to develop robust procedures for identifying potential violations of internal reporting and disclosure controls.  This will be a difficult process.  Along with the...