Fraud and Abuse

News & Analysis as of

US govt. spent $100B in improper payments | Governmental Mismanagement?

If you’re an American taxpayer, I have some bad news for you. According to recent reports by federal agencies, $100 billion in payments were made last year to people who may not have been supposed to receive them....more

An Ounce of Fraud Prevention Is Worth Trillions of Dollars

A recent study, Report to the Nations on Occupational Fraud and Abuse: 2014 Global Fraud Study from the Association of Certified Fraud Examiners (ACFE) analyzed nearly 1,500 cases of occupational fraud as reported the...more

Is $210 Million Enough? How About $54.2 Million?

On June 25, 2014, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) issued and certified, as required by the Small Business Jobs Act of 2010...more

Brace for Medicaid data mining and recoupment demands

The federal Health and Human Services Office of Inspector General (OIG) is escalating its war against Medicaid fraud and abuse, just as it has over the past years with Medicare. The OIG’s focus has turned to early prevention...more

OIG Revamps Regulations Concerning CMPs and Exclusion

In a pair of proposed rules published in May, the HHS OIG unveiled changes to the regulations concerning OIG’s authority to impose civil monetary penalties (CMPs) and exclude individuals and entities from participation in...more

HHS OIG Releases Proposed Rules Regarding Increased Authority to Combat Fraud and Abuse under the ACA

The Office of Inspector General (OIG) of the Department of Health and Human Services proposed two new rules last week in order to expand its enforcement authority, implementing changes adopted as part of the Patient...more

Updated E-Filing Requirements for Tax Preparers

In the IRS's point of view, preventing fraud and abuse of the electronic filing system is the shared responsibility of both the IRS and authorized e-file providers. In an effort to stop the fraud, abuse, and resulting...more

Lifeline Database Update: NLAD Operational in All States, FCC Announces Success

The FCC’s National Lifeline Accountability Database (“NLAD”) now is operational in all states and has already had a significant impact in reducing waste, fraud, and abuse. The FCC announced today that, so far, the NLAD has...more

Illinois AG Sues To Enforce Dodd-Frank “Abusive” Prohibition

On March 19, Illinois Attorney General (AG) Lisa Madigan announced a suit against a lender for allegedly offering a short-term credit product designed to evade the state’s usury cap. The AG claims the lender offers a...more

"OECD Outlines Plans to Prevent Double-Tax Treaty Abuse"

On March 14, 2014, the Organisation for Economic Co-operation and Development (OECD) published a discussion draft report on preventing double-tax treaty abuse (the Treaty Report). The OECD supplemented this release on March...more

Part II: Exploration of Common Exceptions to the Stark Law

In this Presentation: Kristin Cilento Carter presented “Exploration of Common Exceptions to the Stark Law” as part of the program “Stark Physician Self-Referral Law,” an installment in the Fraud and Abuse Basics...more

Blow Your Green Whistle to Protect the Environment

The Office of Inspector General is an independent office within the U.S. Environmental Protection Agency (EPA) that assists the agency in accomplishing its goals more efficiently. OIG conducts audits, investigations and...more

Trade group criticizes CFPB reliance on enforcement and informal guidance

The U.S. Chamber of Commerce’s Center for Capital Markets Competitiveness has sent a detailed letter to Director Cordray in which it criticizes the CFPB’s approach of “regulation by enforcement settlement combined with...more

Office of Management and Budget (OMB) Reviewing Two Proposed Fraud & Abuse Rules

On February 5, 2014, the OMB received two proposed rules from the Department of Health and Human Services Office of the Inspector General (OIG). One proposed rule would, among other things, update OIG’s regulations to...more

OIG's 2014 Work Plan: A Roadmap to Key OIG Fraud and Abuse Priorities

The Department of Health and Human Services, Office of the Inspector General (OIG) released its Fiscal Year (FY) 2014 Work Plan on January 31, 2014. While the OIG usually releases its work plan in October of each year, in...more

OIG Plans to Fight Fraud, Waste, and Abuse While Promoting Quality, Safety, and Value in 2014

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Work Plan for Fiscal Year 2014 on January 31, 2014. The Work Plan provides insight into the OIG’s priorities by providing...more

Do Misstated Financial Statements Cause CEOs To Speed?

Should companies look into the driving records of the CEOs that they hire? Robert H. Davidson, Aiyesha Dey, and Abbie Smith answer that question in a forthcoming Journal of Economics paper. These authors examined a sample...more

OIG Releases 2014 Work Plan

The OIG recently made available its 2014 Work Plan. The Plan identifies OIG focus areas and priority projects for the coming year. This post provides a brief summary of many of the new OIG projects for fiscal year 2014 to...more

Judicial Review of Government Contractor Suspensions

In recent years, the U.S. government has exercised enhanced scrutiny over federal contractors through, among other things, the increased use of its suspension and debarment remedies – fueled in part by reports of contractor...more

USCIS to Expand Site Visit Program to Include L-1 Petitioners

Employers of L-1 transferees should now set up processes to deal with such visits. U.S. Citizenship and Immigration Services (USCIS) recently announced its intention to begin conducting worksite inspection visits to...more

Predictions For Top 10 Healthcare Stories For 2014

The past year was one of the most eventful in recent memory for healthcare policy. As the Affordable Care Act ("ACA") continued its inexorable, albeit at times wobbly, march towards implementation, the headlines became more...more

OMB Publishes Final Uniform Guidance on Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards

On December 26, 2013, the Office of Management and Budget (“OMB”) published final guidance in the Federal Register entitled “Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards”...more

OIG Defines its Priorities in 2014-2018 Strategic Plan

Outlining its high-level priorities and goals for the next five years, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published its Strategic Plan for 2014-2018. In the Strategic...more

INTERPOL and the CCF's 2012 Annual Report- the CCF looks to strengthen its role

(This is the third post in a series about the CCF's 2012 Annual Report) Each year, the Commission for the Control of INTERPOL's Files (CCF) submits its annual report at the General Assembly meeting. The report is...more

Former Broker Banned by FCA for Encouraging Market Abuse

On November 14, the FCA published the final notice it has issued to Rahul Shah. The FCA’s statement is that Mr. Shah encouraged another person to engage in behavior which, had Mr. Shah engaged in that same behavior, would...more

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