Fraud

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
News & Analysis as of

The Deeper Dive: C-Suite to Prison Pipeline

In recent years, the U.S. Department of Justice (DOJ) has been criticized for failing to prosecute executives for fraud, particularly in the financial sector. In response, the DOJ has begun to more heavily emphasize...more

Blog: OIG Reports Targeting Medicare Part D Fraud Issued on the Heels of National Medicare Fraud Sweep

The Health and Human Services (HHS) Office of Inspector General (OIG) released two reports yesterday related to Medicare Part D fraud. The OIG report, Ensuring the Integrity of Medicare Part D, “synthesizes numerous OIG...more

The Federal and Nevada False Claims Acts

Contractors are no strangers to the courts of justice. Litigation between contractors and owners frequently occurs when a project does not get completed on time or the work does not comply with the Contract Documents. The...more

Washington Healthcare Update

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

Fraud and the Detection of the Sources for Bribery

In a recent White Paper authored by Peter Smith for OFS Portal, entitled “Procurement and Fraud in the Supply Chain”, where he examined “fraud linked to procurement and supply chain activities.” Smith focuses on where fraud...more

Regulators' Actions Against Charities that Swindled $187 Million from Donors Serve as Compliance Reminder

On May 18, 2015, the Federal Trade Commission (FTC) and 58 agencies from all 50 states and the District of Columbia filed a complaint charging four cancer charities and the individuals controlling them with allegedly...more

Void-for-Vagueness Challenges to Section 75-1.1

This month’s Clark v. Toyota decision from the U.S. District Court for the Western District of North Carolina has a number of interesting features, as we noted in our last post. Today, we’ll look at another one of those...more

Bridging the Week - June 2015 #4

Investment Adviser Chief Compliance Officer Blamed in SEC Lawsuit for President’s Theft of Client Funds; SEC Commissioner Criticizes Enforcement Actions Against CCOs Generally - The Securities and Exchange Commission...more

New York Court Holds Fraudulent Act Exclusion Applicable in LPL Policy

In its recent decision in Lewis & Stanzione v. St. Paul Fire & Marine Ins. Co., 2015 U.S. Dist. LEXIS 78259 (N.D.N.Y. June 17, 2015), the United States District Court for the Northern District of New York had occasion to...more

SEC Commissioner Gallagher: Guidance is Needed For IA CCOs

SEC Commissioner Daniel Gallagher published a statement explaining his dissent in two recent enforcement actions in which the Chief Compliance Officer of an investment adviser was charged, noting that the trend in such...more

Fourth Circuit Affirms Conviction in Virginia Bank Fraud Case

The US Court of Appeals for the Fourth Circuit recently affirmed convictions for conspiracy to commit bank fraud and other related charges against three former executives of the Bank of the Commonwealth. In 2008, the...more

Bankruptcy Beat: Former NFL Player Defeats Fraud Allegations Which Results In Discharge Of Debt

On March 31, 2015, the Honorable Albert S. Dabrowski issued a decision in Hamrah v. Coulette (In re Coulette), Adv. Pro. No. 13-2039, concerning the issue of whether an obligation created by a failed business investment gives...more

Appellate Courts + STOLI = Mixed Results

In recent years, federal district courts addressing claims and defenses with respect to stranger-originated life insurance (STOLI) schemes have reached a variety of results. Accordingly, federal appellate courts have...more

Financial Markets Disputes and Regulatory Update - Summer 2015 Issue 1

In This Issue: - What is worth remembering from the first half of 2015? - Judgments - so far this year… ..Jurisdiction for claims in relation to bearer bonds ..Exercise of contractual rights by...more

Provider Alleges Retaliatory Use of Medicare Payment Suspension

A federal court has ordered discovery regarding the circumstances of a Medicare payment suspension by CMS only one week after failed settlement negotiations between a cardiology practice and the Department of Justice (DOJ) to...more

Crowdfunding Isn’t Charity

“How do I get backers for my project?” - You see this question asked frequently on social media sites. The projects are sometimes serious, but have often advanced little more than a dream. The person seeking funds may...more

SEC Sues For-profit College Over Alleged Loan Fraud

A major for-profit education corporation is facing a lawsuit from the U.S. Securities and Exchange Commission (SEC) because of allegedly fraudulent activity by the company’s chief executive officer and chief financial...more

Pennsylvania Court Dismisses Data Breach Claims

In 2014, the University of Pittsburgh Medical Center’s computer system was hacked, resulting in the disclosure of sensitive personal information of current and former employees, including names, addresses, birthdates, social...more

Crowdfunding Project Creator Settles FTC Charges of Deception

In the FTC's first case involving crowdfunding, the agency took action against a project creator who was ostensibly raising money from consumers to produce a board game, but instead used most of the funds on himself....more

US v. Heinz May Bolster Expansive FIRREA Interpretation

The U.S. Department of Justice’s aggressive use of the Financial Institutions Reform, Recovery, and Enforcement Act to sue banks for fraud just received an unexpected boost, and from an unlikely source: In a criminal case...more

The Ethics of Internal Investigations, Domestic and Abroad: Protecting the Attorney Client Privilege during Internal...

The attorney-client privilege and the work product doctrine are two of the oldest and most sacrosanct privileges in the law. The attorney-client privilege protects the functioning of the attorney and client...more

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

Why Should Americans Care About the FIFA Indictments? Part IV – Corruption is a Global Scourge

Today, I conclude my four-part series on the above question posed to me recently by a colleague. In Part I, I responded that only the US government had the wherewithal and will to do so and that it continued the...more

OIG Warns Physicians of Potential Exposure for Unlawful Compensation Arrangements

While the Department of Justice and the Department of Health and Human Services Office of Inspector General (OIG) have long scrutinized physician compensation arrangements, including medical director agreements, penalties...more

Blog: OIG Issues Fraud Alert re: Physician Compensation Arrangements

The U.S. Health and Human Services Office of Inspector General (OIG) released a Fraud Alert today titled Physician Compensation Arrangements May Result in Significant Liability. The OIG directs health care professionals...more

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