The Affordable Care Act included a mandate that medical service providers and suppliers enact compliance programs as a condition of participating in federal health care programs. (The ACA also set a deadline of March 23, 2013, for skilled nursing facilities and nursing facilities to implement a compliance program). The ACA requires HHS and the Office of the Inspector General (OIG) to establish core elements for...

BNP Paribas’ recent settlement of nearly $9 billion for violating US Sanctions against Sudan, Iran and other countries is another important achievement for the US Attorney’s Office in the Southern District of New York and the Department of Justice. For other global financial institutions, the BNP settlement has to cause some anxiety. A number of other financial institutions engaged in similar conduct with regard to...

Chief Compliance Officers have a tough job. It does not matter what industry they are working in, CCOs face a myriad of challenges. The healthcare industry, however, has its own set of challenges. While there has been a “long” tradition (since the 1990s) of compliance in the healthcare industry, that has not translated into a robust commitment to elevating CCOs and ensuring they have access...

Every company claims that they encourage a “speak up” culture. As part of a “speak up” culture, companies encourage managers and employees to raise concerns about potential violations and promise not to retaliate against anyone who raises a concern. Some companies mean what they say and some do not. The SEC recently brought its first enforcement action against a company for retaliating against a whistleblower....

You have to admire the vigilance and dedication of prosecutors and law enforcement investigators who fight Medicare fraud. There is no question that they have ramped up enforcement and promoted a strong message of deterrence. Consider the nature of the problem. The FBI estimates that between five and ten percent of all healthcare expenditures (government and private) are fraudulent. Medicare suffers huge annual losses from...

As CCOs become a key player in the corporate governance world, ethics and compliance leaders are developing principles to be used by compliance pofessionals. It is a natural process that reflects the growing “professionalization” of the compliance profession. It would be helpful for compliance officers to develop their own code of conduct, i.e. a set of general principles to help guide compliance professionals in their...

July 8, 2014, 12 Noon EST SIGN UP HERE Companies have designed and implemented anti-corruption compliance programs.  An important element of an effective compliance program is monitoring and auditing the program to identify issues for improvement. Working in collaboration with the Internal Auditor, Chief Compliance Officers have to rely on tailored monitoring and auditing procedures to identify issues for review to ensure improvement of a...

Lauren Connell, Managing Associate at The Volkov Law Group, joins us again for an interesting post on the GM scandal.  Lauren’s bio is here and she can be reached at lconnell@volkovlaw.com. 44 recalls. 13 deaths. 20 million vehicles. 9 years. 3 Congressional appearances. These five numbers tell a terrible and tragic story you probably recognize as the GM ignition switch recall debacle. This is a...

As Chief Compliance Officers rise in the corporate hierarchy, they will become the focus of more enforcement actions. This increased focus on prosecution of CCOs could have a chilling effect on their performance and the rapidly increasing pool of talent seeking to enter the compliance profession. As always, the devil is in the details. Just because a CCO has the title CCO, does not mean...

When reading about corporate governance, it is hard not to get frustrated. So-called “experts” in the field provide little practical advice but are filled with platitudes that apply to corporate boards, senior management and governance. Acronyms are bandied about as a special language is only understood by the great thinkers in the GRC discipline. Everyone needs to take a step back, agree on some basic...