“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...
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...
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)...
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...
The FCPA Guidance is an advertisement for the government’s voluntary disclosure program. DOJ and SEC repeat their message – if you voluntarily disclose, you will get a benefit. As demonstrated in the declinations, companies that disclose will receive a benefit. While I am reluctant to point to bring religion into the FCPA arena, the FCPA Guidance describes the disclosure process in a cleansing way, like...
The FCPA Guidance includes some important reminders for compliance practitioners. Most significantly, DOJ and SEC want companies to reinvigorate their risk assessment process. In the absence of an effective risk assessment, companies are likely to allocate compliance resources without proper regard for specific risks. Such a deficiency will permeate every element of a compliance program. As a result, companies will develop “paper” compliance programs which...
Healthcare fraudsters do not discriminate between private and public medical insurance. Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies. Most healthcare providers bill public and private payers. For example, a health care provider may be billing Medicare, Medicaid and several private health plans (in-network and out-of-network). Private insurance companies also provide insurance as Medicare Parts C and D contractors or...
I find the so-called “vampire” cultural phenomena scary – I do not understand what is so entertaining about “ordinary” people who can suddenly turn into vampires, let alone enter into “serious” relationships with each other or with so-called “normal” humans. Maybe I am stuck in the past when “Night of the Living Dead” was more my cup of tea. Whatever your attitude toward death and...
I am really enjoying reading and re-reading the FCPA Guidance. It is a fascinating document, well written and chock full of salient points, messages, explicit and implicit. For me, the most important issues are those that are in the so-called “gray area.” Some of the hypotheticals and the anonymous declinations are easy calls – after reading them, I am positive of the answer. The descriptions...
The Justice Department and the Department of Health and Human Services have made healthcare fraud a number one priority – it is another example of the synergy of politics and enforcement. Congress spends more money on prosecution resources and prosecutors use these resources to bring more criminal and civil enforcement actions. Every few months the government announces another nationwide crackdown and defendants are swept up...
