The United States spends over $2.81 trillion dollars on health care annually and generates billions of claims from millions of health care service and product providers. The vast majority of these providers of services and products bill multiple payers, both private and public. In 2012, the Medicare program covered more than 49 million elderly and disabled beneficiaries at an estimated cost of $555 billion, and...

With all the hoopla over hiring of relatives of foreign officials, it is important to keep in mind the risks and how the FCPA applies. The talismanic concept for tan FCPA violation is “corrupt intent.”  It is always difficult to know what is going on in someone’s mind (unless you are Kreskin from the past).  White collar crimes usually turn on proof of an actor’s...

JP Morgan stands as the poster child for how not to interact and resolve issues with the federal government. After what appeared to be a difficult set of negotiations, the Justice Department and JP Morgan reached a record $13 billion financial settlement to resolve government claims against JP Morgan relating to its actions in the mortgage-backed securities market.  The government stood its ground on an...

This is a very complicated case, Maude. You know, a lotta ins, lotta outs, lotta what-have-you’s. And, uh, lotta strands to keep in my head, man. Lotta strands in old Duder’s head. – The Big Lebowski (1998) Luckily, the Justice Department and SEC’s recent FCPA settlements with Weatherford and Bilfinger do not fall into the Big Lebowski “complicated case” category.  They are both examples of cases...

As global enforcement becomes a reality, companies face a unique set of risks which can be mind-numbing in complications.  With the long-arm reach of the FCPA, UK Bribery Act and other anti-corruption laws, more enforcement actions are focusing on extraterritorial conduct.  Even more complicating is the fact that such conduct is falling under the jurisdiction of multiple companies. This is not something new.  Global antitrust...

The controversy around punishment and deterrence of corporate misconduct continues to swirl.  As fines increase against companies, it is important to ask the question whether the current enforcement scheme adequately punishes and deters corporations. The issue was underscored by recent comments made by JP Morgan’s General Counsel three days after JP Morgan reached a record $13 billion settlement for its mortgage-backed securities activities, who suggested...

When it comes to health insurance fraud, Carl Sagan’s obsession with the words – billions and billions — are particularly accurate. As the government’s role in health care increases, it is inevitable that fraud against the government will increase as well.  The False Claims Act is the primary weapon the government uses to chase fraudsters.  While the government has aggressively ramped up its anti-fraud fight,...

Companies need to recognize the importance of responding effectively to a whistleblower complaint.  The Enron case, and many others after that, started with a whistleblower complaint which the company either ignored or bungled in its response. I have repeatedly advised companies to develop a whistleblower triage strategy for assessing, responding to, and dealing with whistleblowers.  There are a number of ways to set up a...

There are so many potential pitfalls in conducting an internal investigation.  I always say that there is an “art” to conducting an effective internal investigation.  There are so many ways in which an investigator can be derailed, waste resources, and/or lose focus while conducting an investigation.  One of the most common ways in which a company can derail an internal investigation is by failing to...

Everyone knows that a compliance officer does not need to be a lawyer.  Some compliance professionals believe that lawyers do not make very good compliance officers – the jury is out on that.  To me, what matters more is the personal attributes that a person brings to a job – are they positive, persistent, goal-directed, self-effacing, and able to communicate and work together with people....