The Department of Justice continues to trumpet its healthcare fraud program.  Just last week, the Justice Department and HHS announced another nationwide sweep resulting in the arrest of 91 individuals. The Justice Department has dropped its “war on drugs” and replaced it with “war on healthcare fraud.”  The Affordable Care Act recognized that aggressive prosecution of fraud would help to reduce health care costs.  Even...

The fear of corruption can sometimes be overblown.  If corruption fears drive business decisions, the fear is winning and business loses. Global businesses sometimes decide not to enter a new market because of corruption concerns.  Such a decision is usually short-sighted.  It also reflects a fundamental governance failure – you can rest assured that the business failed to include compliance professionals in such a determination. ...

Hospital administrators should be nervous.  The Justice Department and HHS are out to pressure service providers, including hospitals and doctors, to reduce costs.  In Washington, hospitals and doctors are perceived to be a big part of the problem of rising health care costs: they gouge the system to line their own pockets. In September, Attorney General Holder and HHS Secretary Sebelius warned hospitals that they...

World Compliance is holding an annual event on November 1, 2012, at Sofitel Hotel in Miami, Florida.  World Compliance is a sponsor of this blog and the leading open intelligence source business. Please register here.   The annual event includes an impressive list of speakers, including: 1.  Dirk Mohrmann, CEO WorldCompliance  2.  David Nanz, Supervisory Special Agent FBI Miami: “Trends in Financial Crime”  3.  Dennis...

Join me and Tom Echikson (Tom's profile is here) for a webinar on October 24, 2012 at 12 noon EST to examine civil and criminal environmental enforcement and compliance issues.  Please sign up here. Civil and criminal environmental enforcement is on the upswing. Almost daily the EPA issues press releases touting its latest success. This webinar will review EPA's civil and criminal environmental enforcement program,...

Stephen I. Siller from LeClariryan is our guest contributor today.  Stephen is a member of the corporate services and international transaction practices.  His bio can be viewed here. For international companies seeking to tap into the American market through U.S.-based acquisitions or existing subsidiaries, the cost of compliance slipups can be high indeed. This is true whether the parent is a tech start-up from Asia...

Everyone in the compliance arena is tired of the refrain: document, document, document.  It is easy advice but difficult to implement on a consistent basis.  It is hard to justify the time and effort needed to document compliance steps when the risk appears to be remote.  Turning this equation around requires education, training and commitment.  Compliance professionals know when documentation should be required.  The question...

Sometimes the deck is stacked against you.  No matter what you do and how hard you try, you will lose.  In the healthcare area, hospitals, doctors and other service providers have to feel the frustration when it comes to the False Claims Act and potential liability for federal overpayments which they hold (or fail to return) for longer than 60 days.  Even when exercising good...

It is interesting to compare how the Justice Department handles compliance issues in different contexts.    The Justice Department, with the Office of Inspector General/Health and Human Services, enters into Corporate Integrity Agreements to prevent off-label marketing violations, anti-kickback and False Claims Act violations.  CIAs are very detailed and prescriptive, and are enforced by the OIG using administrative procedures.  The CIA is not filed in court...

Patrick Kellermann from LeClairRyan returns with a timely post on data security.  His profile can be viewed here. When people hear “data security” they think technical jargon: firewalls, passwords, encryption, yada, yada, yada.  They leave it up to “Nick,” the company computer guy (SNL reference), and quickly turn to the day’s pressing business matters.  Guess what, if your company handles individuals’ sensitive information in any...