As new areas of the law emerge, driven in part by technology and the free flow of information, federal agencies are becoming more aggressive with a tried and true carrot-and-stick approach to law and regulatory enforcement. ...more
7/15/2024
/ Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Government Agencies ,
Incentives ,
Pilot Programs ,
Regulatory Oversight ,
Securities and Exchange Commission (SEC) ,
Securities Exchange Act of 1934 ,
Securities Violations ,
Voluntary Disclosure ,
Whistleblower Awards ,
Whistleblower Protection Policies ,
Whistleblowers ,
White Collar Crimes
On 7 February 2023, the US Department of Justice (DOJ) publicly reported the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2022. While the DOJ emphasized in its accompanying press release that “the...more
U.S. Department of Justice (DOJ) Deputy Attorney General Lisa Monaco presented a new policy at a Securities Industry and Financial Markets Association event that requires chief compliance officers (CCO) to certify that...more
In a significant departure from the general downward trend in False Claims Act (FCA) civil fraud recoveries over the past half-decade —and as predicted last year —recoveries in Fiscal Year (FY) 2021 drastically increased...more
Introduction - Privilege assertions and waivers are a hot area for internal investigations and government proffers. One burning question centers around whether a party may claim privilege over materials that it furnished to...more
In a keynote address to the American Bar Association’s 2021 National Institute on White Collar Crime, Deputy Attorney General (DAG) Lisa O. Monaco outlined major changes to the U.S. Department of Justice’s (DOJ) priorities...more
False Claims Act (FCA) civil fraud recoveries in Fiscal Year (FY) 2020 dropped over US$850 million when compared to those in FY 2019. While the more than US$2.2 billion in recoveries in FY 2020 continued a general downward...more
This edition of Qui Tam Quarterly focuses on:
- the history of big data in health care FCA investigations and litigation;
- how the government has increased its ability to gather health care claims data and use it to...more
As many corporate practitioners know from experience, U.S. Department of Justice (DOJ) lawyers and federal prosecutors often factor a company’s inability to pay into corporate civil and criminal resolutions with the...more
On this week’s episode, John Lawrence, Myla Reizen and Mark Rush discuss the devastating effects COVID-19 has had on nursing homes and long term care facilities in the United States and potential civil and criminal liability...more
In response to the economic crisis caused by the spread of COVID-19, Congress passed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) on March 27, 2020, which President Donald J. Trump subsequently signed...more
In recent days, federal and state authorities have prioritized enforcement related activities aimed at combatting fraud schemes arising out of the public uncertainty and desperation caused by the COVID-19 pandemic. ...more
In 2019, the False Claims Act (“FCA”) remained the federal government’s (“Government”) primary method of civil fraud enforcement. While the more than $3 billion in civil fraud recoveries in Fiscal Year (“FY”) 2019 resulted...more
New frontiers are emerging in health care as burgeoning technologies merge with health care’s ever-evolving landscape. While these new frontiers provide seemingly endless possibilities and opportunities for improving the...more
In 2018, the False Claims Act (“FCA”) continued to be one of the federal government’s (“Government”) preferred civil fraud enforcement tools across a variety of industries. The healthcare industry, however, remained the...more
In Part 3 of our series on health care investigations, Mark Rush and John Lawrence discuss the process for external investigations conducted by federal and state governmental agencies, including in the context of qui tam...more
11/27/2018
/ Civil Investigation Demand ,
Dismissals ,
Employee Rights ,
False Claims Act (FCA) ,
Frivolous Lawsuits ,
Government Agencies ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
Internal Investigations ,
Obstruction of Justice ,
Qui Tam ,
Search & Seizure ,
Search Warrant ,
Subpoenas ,
Whistleblowers
In Part 2 of our series on health care investigations, Mark Rush and John Lawrence continue the discussion on internal investigations. Specifically, the episode walks through how to conduct an internal investigation,...more
11/27/2018
/ Audits ,
Bias ,
Corrective Actions ,
Data Collection ,
Disclosure Requirements ,
Document Destruction ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Healthcare Workers ,
Internal Investigations ,
Interviews ,
Outside Counsel ,
Policies and Procedures ,
Reporting Requirements ,
Self-Disclosure Requirements ,
Upjohn Warnings
In this episode, Mark Rush and John Lawrence discuss the federal government’s expectations related to health care organizations conducting internal investigations and demonstrating a commitment to compliance. The episode also...more
10/30/2018
/ Anti-Kickback Statute ,
Civil Liability ,
Civil Monetary Penalty ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Internal Investigations ,
OIG ,
Qui Tam ,
Risk Mitigation ,
Stark Law
Recently, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced its largest ever national health care fraud takedown, resulting in charges against 601 diverse defendants including...more
7/19/2018
/ Anti-Fraud Provisions ,
Anti-Kickback Statute ,
Bribery ,
Corruption ,
Criminal Conspiracy ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Drug Distribution ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
FBI ,
Health Care Providers ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
Medicare Fraud Strike Force ,
OIG ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
State Attorneys General ,
TRICARE
The features that make cryptocurrencies attractive to their users — relative anonymity and mobility — have created heightened concerns with regulatory agencies in the United States and abroad. Recent enforcement actions...more
Attorney General Jeff Sessions announced the creation of the Prescription Interdiction & Litigation (“PIL”) Task Force –– which Sessions described as a “new front in the war on the opioid crisis” –– in a February press...more
Recently, an American bank entered into a deferred prosecution agreement requiring it to pay over US$610 million in penalties. The plea agreement was based on “impos[ing] hard caps on the number of transactions subject to AML...more
A recently leaked U.S. Department of Justice (“DOJ”) memorandum asks government attorneys to consider seeking the outright dismissal of “meritless” qui tam actions filed under the False Claims Act (“FCA”). The eight-page...more
A split now exists among the circuit courts as to whether a defendant’s assertion of a “reasonable interpretation defense” precludes a finding of a “knowing” mens rea under the False Claims Act (the “FCA”). On May 26, 2017,...more
Over the past two years, financial regulatory bodies in the United States and Europe have increasingly emphasized consumer due diligence (“CDD”) by financial institutions as a means to combat money laundering and terrorist...more
11/30/2016
/ Anti-Money Laundering ,
Customer Due Diligence (CDD) ,
Department of Justice (DOJ) ,
Due Diligence ,
EU ,
FATF ,
Financial Institutions ,
FinCEN ,
Member State ,
Office of Foreign Assets Control (OFAC) ,
Terrorism Funding ,
Virtual Currency