Steps Your Nonprofit Can Take to Mitigate Fraud Risks - Part 2
Fraud Risks at Nonprofit Organizations - Part 1
Digital Planning Podcast Episode: Estate Planning and the Corporate Transparency Act
The Presumption of Innocence Podcast: Episode 38 - A Blueprint for Compliance: The Fraud Pentagon Theory
FCA Uncovered: Mitigating Risk in the Regulatory Spotlight — Regulatory Oversight Podcast
Tackling Credit Push Fraud: Understanding Nacha's Risk Management Package (Part Two) — Payments Pros: The Payments Law Podcast
False Claims Act Insights - Think You Know Whistleblowers? Think Again.
PilieroMazza Annual Review What DOJ’s Annual FCA Report Means for Government Contractors
Ad Law Tool Kit Show – Episode 6 – Mitigating Class Action Exposure
Compliance into the Weeds: The ACFE 2024 Anti-Fraud Technology Benchmarking Report
AD Nauseam: Cabbage Soup v. Keto Diet: The Evolving FTC and NAD Approach to Post-Holiday Weight Loss Claims
The Justice Insiders Podcast: The Sam Bankman-Fried Trial: Defendants Testifying (Poorly), FOMO, and How to Actually Blame Lawyers
Detecting Fraud in New Jersey Workers' Compensation
The Presumption of Innocence Podcast: Episode 25 - An Investigative Journalist’s Insight Into the COVID-19 Fraud Strike Force
Medical Device Legal News with Sam Bernstein: Episode 11
JONES DAY TALKS®: Looking for ESG Fraud – CFTC Solicits Carbon Markets Whistleblowers
ChatGPT Risks for Compliance Programs
The Justice Insiders Podcast: Varsity Blues Reversals Turn DOJ Red
Giving Compliance Advice
Crypto Enforcement Actions - The Crypto Exchange Podcast
The U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more
After conducting a thorough and privileged internal investigation, it becomes evident that your Company has overcharged the government over $50 million, and that the fraud was directed by a high-level manager. What do you do...more
Last week, the U.S. Department of Justice (DOJ) announced a $22.4 million settlement resolving allegations that Martin’s Point Health Care, Inc. (Martin’s Point) violated the False Claims Act (FCA) by submitting inaccurate...more
The Department of Health and Human Services’ Office of Inspector General (“OIG”) willmodernize its Compliance Program Guidance (“CPG”) beginning at the end of calendar year 2023. The updates will be posted on the OIG website...more
During the federal fiscal year ending in September, 2022, the Department of Justice collected more than $1.7 billion in False Claims Act (FCA) settlements and judgments involving fraud in Medicaid, Medicare Advantage (MA)...more
The nation’s biggest health insurers are gaming a giant program to provide health coverage to seniors, exploiting the privatization of Medicare Advantage plans to rake in profits with schemes that have drawn fire from...more
Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more
A pair of reports recently issued by the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) highlight the important role telehealth services have played in ensuring access to medical...more
DOJ Secures $5.6 Billion in False Claims Act Recoveries in Fiscal Year 2021 - On February 1, 2022, the U.S. Department of Justice (DOJ) announced that the Department recovered approximately $5.6 billion in False Claims Act...more
Each year, the Department of Justice (DOJ) recovers millions of dollars through False Claims Act (FCA) settlements, and 2021 was no exception. Some of the most sizeable or otherwise noteworthy settlements from 2021 were with...more
On October 25, 2021, DOJ intervened in a False Claims Act (FCA) case against Kaiser Permanente, Kaiser Foundation Health Plan, Inc., and certain Permanente Medical Groups (Kaiser). In its complaint, DOJ contends that Kaiser...more
On February 8th, the U.S. Department of Justice (DOJ) quietly issued new guidance on how the agency evaluates corporate compliance programs during fraud investigations. The guidance, published on the agency’s website as the...more
In late June, the New York Court of Appeals affirmed a trial court ruling that there was no coverage for a health insurance company policyholder, under a “Computer Systems Fraud” rider issued by its insurer, for an underlying...more
This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more
Senator Grassley issued letters this week to the Centers for Medicare and Medicaid Services (CMS) and Department of Justice (DOJ) related to potential fraud in the Medicare Advantage program. Citing news articles, DOJ...more
On February 24, 2012, the Department of Health and Human Services Office of the Inspector General (OIG) published the results of its study entitled “Medicare Advantage Organizations’ Identification of Potential Fraud and...more