First, DOJ updated its interpretation of one of the three “fundamental questions” that an evaluating prosecutor should ask. In addition to determining whether the company’s compliance program (1) is well designed and (2) works in practice, prosecutors should also consider (3) whether the program is being applied earnestly and in good faith. The updated guidance explains that this third question requires prosecutors to determine if the program is “adequately resourced and empowered to function effectively.”
FinCEN Releases First Advisory on COVID-19 Illicit Activity, Including New Red Flags for Potential COVID-19 Fraud and Scams
On May 18, 2020, the Department of Treasury's Financial Crimes Enforcement Network (FinCEN) released its first advisory to financial institutions about detecting and preventing COVID-19 fraud. The guidance provides financial institutions with 22 red flag indicators to help identify potential illicit activity related to the pandemic, such as price gouging and hoarding medical supplies; fraudulent cures, tests, and vaccines; and non-delivery scams. FinCEN plans to issue additional advisories about financial crimes related to the pandemic in the future.
In a letter released Thursday, April 16, 2020, the U.S. Attorney for the Eastern District of Pennsylvania called on area hospitals, health systems, and other providers to join the government's fight against coronavirus-related fraud. Hospitals, providers, and other health care institutions are on the front lines of the coronavirus pandemic and know first-hand the challenges in obtaining critical supplies. They also are in a unique position to identify COVID-19-related fraud, such as offers to sell non-existent or fake equipment and price gouging of supplies.
FinCEN Imposes Civil Money Penalty on Former Bank Officer for Failing to Adequately Staff Bank's AML Compliance Function and for Capping Bank's Suspicious Activity Reports
In February, 2018, FinCEN and the Office of the Comptroller of the Currency imposed a $185 million civil money penalty on U.S. Bank N.A. for willful violations of the Bank Secrecy Act (BSA), including failing to establish and implement an adequate anti-money laundering (AML) program and failing to report suspicious activity. On March 4, 2020, FinCEN imposed a $450,000 civil money penalty on the Bank's former Chief Operational Risk Officer for his role in these failures.
Signs of Increased Prosecution of Executives Illustrate the Yates Memo's Staying Power and Increased Risks for Corporate Owners and Insiders
When originally issued in September 2015, the "Yates Memo" was an effort by the U.S. DOJ and then-DAG Sally Yates to strengthen the Department's commitment to holding executives and other responsible individuals at corporations criminally liable for their companies' malfeasance. Although the Yates Memo's future under the current Administration has been at times uncertain, a series of recent prosecutions of corporate insiders suggests that the principles the Yates Memo embodies are here to stay.
On March 12, 2019, the DOJ unveiled "Operation Varsity Blues," its nationwide college admissions bribery and entrance exam cheating investigation. Critical for DOJ is evidence gathered from recorded conversations between William Singer and coaches, his clients, and others while he wore a government wire. I recently examined this aspect of the investigation in an article for PACDL's For the Defense.
Pennsylvania Supreme Court Puts Employers on Notice: You Can Be Liable When Hackers Breach Your Systems
The Pennsylvania Supreme Court has recast two key legal principles that have stood as crucial bulwarks against liability for employers and other businesses that find themselves hacked by malicious third parties. The decision, Dittman v. UPMC, has the potential to usher in a new era of data breach litigation in Pennsylvania. It stands as a strong warning to Pennsylvania employers that they should act now to review and assess the adequacy of their data security.
The SUPPORT for Patients and Communities Act, enacted on October 24, 2018 to combat the opioid epidemic, created a new criminal kickback prohibition for addiction treatment-related services. Codified at 18 U.S.C. Â§ 220 and entitled â€œEliminating Kickbacks in Recovery Act of 2018," it criminalizes paying for patient referrals or offering inducements to patients receiving addiction treatment services. Each violation is punishable by up to 10 years' imprisonment and a $200,000 fine.
On November 14, 2018, IRS Criminal Investigation Division (â€œCIDâ€) released its Annual Report for fiscal year 2018, detailing its enforcement actions for the past fiscal year. CID is the federal enforcement agency with exclusive jurisdiction over federal tax crimes, i.e., Title 26 and 31 offenses.
OIG 15-Year Exclusion for False Claims Act Violations by Lab Company and its CEO Sends Warning to FCA Defendants
On August 17, 2018, a Department of Health and Human Services ALJ affirmed HHS OIG's 15-year exclusion of BestCare Laboratory Services, Inc. and its CEO from federal health care programs pursuant to the OIG's permissive exclusion authority. The exclusion was based on BestCare's submission of false claims for mileage reimbursement which violated CMS billing restrictions and formed the basis of a qui tam False Claims Act action, culminating in a $30 million damages award.
Eastern District of Pennsylvania Forms Civil Enforcement Strike Force Adding Resources to False Claims Act Cases
On August 1, 2018, U.S. Attorney for the Eastern District of Pennsylvania William M. McSwain announced the formation of an Affirmative Civil Enforcement (â€œACEâ€) Strike Force within the U.S. Attorney's Office Civil Division. The ACE Strike Force's mission is to bring "additional firepower" to investigations and lawsuits that â€œprosecute fraud and abuse against government programs, including healthcare and procurement fraud,â€ as well as to enforce federal civil rights statutes and "combat the opioid crisis." The ACE Strike Force will initially include five Civil AUSAs and a team leader.Â
Criminal suspects and subjects of investigations frequently are asked by law enforcement to consent to searches of their possessions, such as vehicles and bags during traffic stops, and even their homes. Trying to be cooperative, many initially agree, but later change their minds when officers' actions go beyond their comfort or expectations. Although it has long been settled that an individual can limit the scope of a consensual search, perhaps surprisingly, whether that consent could be revoked was an open question in the Third Circuit until recently. On August 1, 2018, the court answered that question in the affirmative.