Compliance Investigations & White Collar


Deadline Fast-Approaching for Medicaid Managed Care Participating Providers
November 7, 2017 | Geoffrey R. Kaiser | Ashley S. Osadon
The deadline for required enrollment with Medicaid under the Federal 21st Century Cures Act (Cures Act) is fast approaching. Currently, Medicaid Managed Care providers are sending mass mailings to their participating providers with notices of required compliance. By December 1, 2017 certain participating healthcare providers of New York State Medicaid Managed Care plans or the …
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OIG Audit Discovers $51.6 M in Overpayments to Acute-Care Hospitals
October 17, 2017 | Geoffrey R. Kaiser | Jonathan D. Salm
The Office of the Inspector General of the Department of Health and Human Services (OIG) issued a report last month regarding inappropriate payments made to acute-care hospitals for outpatient services provided to Medicare beneficiaries who were inpatients of other facilities. OIG’s findings highlight the need to diligently review claims before submitting them to Medicare. In …
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OMIG Issues New Compliance Alert for NY Medicaid Program
October 13, 2017 | Marc A. Antonucci
A recent Compliance Alert published by the New York State Office of Medicaid Inspector General (OMIG) underscores the need for Medicaid providers to re-evaluate their compliance programs in light of a shift toward new payment methodologies. On August 31, OMIG published its first Compliance Alert of 2017, entitled “Mandatory Compliance Programs’ Risk Assessments: Changes in …
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Shapiro Publishes Article in Natural Products Insider
September 14, 2017 | Steven Shapiro
Steven Shapiro has published an article in Natural Products Insider entitled, “A Legal Look at the Definition of ‘Clean Label’.” Click here to read the article. …
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Shapiro Quoted in BevNET
May 15, 2017
Steven Shapiro weighed in on the FDA’s warning letter to JÙS By Julie over health claims. The company markets a variety of blended ready-to-drink blended smoothies and shots as well as soups and salads. Steve compared JÙS By Julie’s situation to similar letters issued to 14 U.S. companies that were fraudulently promoting their products as treatments for cancer. …
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OIG Releases Compliance Program Update
April 18, 2017
On March 27, 2017, the U.S. Office of Inspector General (“OIG”) released a new compliance program guide, Measuring Compliance Program Effectiveness—A Resource Guide (the “Guide”). The Guide was developed by compliance professionals and staff from the U.S. Department of Health and Human Services and OIG, as an effort to help healthcare organizations measure the effectiveness …
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Five Essential Questions To Mitigate Corporate Compliance Risk
November 18, 2016
In an increasingly intense and unforgiving regulatory environment, all healthcare organizations — from small physician practice groups to large health systems — must closely scrutinize areas where they may be vulnerable to fraud and abuse allegations. Corporate compliance programs are useful in this effort, but only if they are well-constructed and aggressively implemented, not merely …
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Rutkin Publishes Article Entitled, “Insight – A Lesson in Cyber”
November 17, 2016
Alan Rutkin article entitled, “Insight – A Lesson in Cyber,” has been published in the November 2016 issue of Best’s Review magazine. Click here to read the article. Best’s Review:  November 2016. Copyrighted A.M. Best Company, Inc. 2016.  All Rights Reserved, Reprinted with Permission. …
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Caffeine’s Rise to Controversy and Popularity in Helping Consumers Attain Energy
September 29, 2016
Caffeine seems to have been around forever. I do not remember my first cup of coffee or my first can of cola, but I do remember the over-the-counter (OTC) stimulant drug products containing 200 mg of caffeine that were an absolute necessity for most of my classmates to survive freshman year of college and first …
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Ransomware: A Threat to Any Business, Large or Small
September 20, 2016
Marc Ullman’s article entitled, “Ransomware: A Threat to Any Business, Large or Small,” was recently published by Natural Products Insider. According to a recent report by Malwarebytes, an anti-malware software company, a whopping 39 percent of the 540 companies from the United States, Canada, Germany and the United Kingdom surveyed in June 2016 suffered some form …
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Kaiser Publishes Article in Corporate Compliance Insights
August 22, 2016 | Geoffrey R. Kaiser
Geoffrey Kaiser has published an article entitled, “False Claims Violations in a Post-Escobar World,” in the August 15, 2016 issue of Corporate Compliance Insights. Click Here to read the complete article. © Copyright 2016 Corporate Compliance Insights. All rights reserved. Geoffrey Kaiser has published an article entitled, “False Claims Violations in a Post-Escobar World,” in …
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Ruling Upholds Law Firm’s In-House Counsel Attorney-Client Privilege
August 12, 2016
In a hotly contested issue of first impression, the Appellate Division, First Department, has joined a multitude of jurisdictions and has ruled that attorneys who seek the advice of their own law firm’s in-house counsel on their ethical obligations in representing a current client of the firm may invoke the attorney-client privilege to resist subsequent …
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Health Care Compliance: Tips For A Corporate Body Self-Exam
July 14, 2016
Given the proliferation of health care regulations and white-hot spotlight of government enforcement efforts, it is becoming increasingly important for all health care organizations, ranging from small physician practice groups to large regional or national health systems, to attain a heightened level of self­awareness concerning areas in which they could be vulnerable to allegations of …
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The Emerging Threat of Ransomware
April 12, 2016
Ottawa Hospital in southeast Ontario, Canada; Hollywood Presbyterian Medical Center in Los Angeles; Lukas Hospital in the German city of Neuss; the California law firm Ziprick and Cramer LLP; solo law practitioner Paul Goodson; and the town of Plainfield, New Jersey all have something in common:  they learned about the cyber threat posed by ransomware …
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Kaiser publishes article entitled, “Prosecutorial Discretion” in Nutrition Business Journal
March 7, 2016 | Geoffrey R. Kaiser
Geoffrey Kaiser published an article in the Nutrition Business Journal entitled, “Prosecutorial Discretion.”  The article discusses the exercise of prosecutorial discretion under the Food, Drug & Cosmetic Act.  It analyzes the factors that enter into a decision by prosecutors to recommend criminal charges, using the recent indictment of USPlabs to illustrate the types of aggravating circumstances …
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Wyndham Worldwide Corp. Settlement with the Federal Trade Commission: Consumer Data Protection Isn’t Only About HIPAA
January 1, 2016
On December 9, 2015, the Federal Trade Commission (“FTC”) announced a settlement ending its two-and-a-half year-long litigation with Wyndham Worldwide Corp., the parent of Wyndham Hotels Group (“Wyndham”).  The case arose from three breaches of Wyndham’s computer systems by hackers in 2008 and 2009 during which personal financial information of thousands of consumers was stolen.  …
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DOJ Policy Memo Urges Prosecutors to Hold Individuals Accountable for Corporate Misdeeds
September 17, 2015
A policy memo issued on September 9, 2015 from Deputy Attorney General Sally Quillian Yates of the Department of Justice (DOJ) outlines a strategy for holding individuals in both civil and criminal enforcement actions accountable for misconduct by corporations and other business entities.  The memo was the product of a working group of senior DOJ …
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