Compliance Programs

Latest Headlines

Latest Headlines

Fraud trends: FCA cases, physician pay will loom large in 2016

With fewer False Claims Act recoveries, some might say 2015 was a down year for federal fraud enforcement. But attorneys across the country say federal policy changes and FCA trends will keep fraud concerns high on the government's radar in the coming year.  

DOJ's new compliance counsel to provide 'reality check'

There's a new face at the Department of Justice this week, and it's one that the agency hopes will provide a "reality check" for corporate compliance programs throughout the country.

Amid increased federal enforcement, compliance guidelines offer foundation for fraud prevention

Governing boards of both health providers and insurers play a crucial role in mitigating compliance risks within their organization, particularly when it comes to identifying and preventing fraud, waste and abuse, Michael Peregrine, a partner with McDermott Will & Emory, told  Compliance Weekly  in a recent podcast.

Supreme Court decision expands False Claims Act liability for providers

The recent  Kellogg Brown & Root Servs., Inc. v. United States ex rel. Carter  Supreme Court decision is a very glass half-full/half-empty ruling for healthcare providers. This could lead to an increase in False Claims Act cases in the future, healthcare attorney George Breen said in an exclusive interview with  FierceHealthPayer: AntiFraud.

As fraud crackdown grows, so does need for corporate compliance

With federal investigators devoting more time and resources towards uncovering fraud schemes involving false claims or kickbacks, corporate compliance programs have never been more important.  

Fraud on the home front: Case lessons for payers and providers

Sometimes trouble is closer than we realize. Lately I've noticed reports of fraud-related criminal prosecutions of those who work with doctors--from physicians' assistants and nurse...

Should the False Claims Act be changed?

Possible changes to the False Claims Act (FCA) animated a congressional hearing last week, as lawmakers heard opposing views on what's been called "the signature anti-fraud weapon of the United States."  

Fraud examiners primed to become the next chief compliance officers

The specialized skills of certified fraud examiners (CFE) make them strong candidates for chief compliance officer roles as companies retool their compliance programs after high-profile corporate wrongdoing in the last decades, according to  Fraud Magazine.

There's hope yet for health plans in the post-reform market

Health payers' thirst for information, success stories and anything else that might help them navigate the pervasive changes required in the post-reform marketplace is evident just by glancing at the