A Practical, New Tool For Understanding and Handling Compliance Programs and Government Investigations
 
April 1, 2000
 

Oceana Publications recently released a valuable new resource in the fight to avoid and defend against federal investigations and prosecutions. Corporate Fraud Investigations & Compliance Programs is a practical, succinct reference tool for developing effective compliance programs, conducting internal investigations, and responding to law enforcement investigations or prosecutions of organizations and/or their officers. The book was authored principally by Eugene M. Propper, a partner in the Washington, D.C. office of Holland & Knight LLP, with support from a number of Holland & Knight attorneys, who drew upon decades of collective experience in addressing these issues.

As the federal government increases law enforcement activities, healthcare organizations are under increasing threat of investigation and prosecution for alleged fraud and abuse. Corporate Fraud Investigations & Compliance Programs lays out, in simple, straightforward language, myriad practical advice and information to assist organizations in avoiding and defending against these kinds of investigations and prosecutions.

A sample of the topics covered includes:

• the potential liability of organizations and their officers and agents for acts by employees or the organization
• the duties of management to address organizational misconduct
• how and when to conduct internal investigations
• how to protect proprietary information and internal investigative results
• the pitfalls and concerns surrounding parallel civil, criminal and administrative proceedings
• the application of the Federal Sentencing Guidelines to organizations
• how to implement an effective compliance program
• forensic accounting for internal investigations

Of particular importance to the healthcare community, Corporate Fraud Investigations & Compliance Programs has a chapter devoted to the statutes and regulations applicable to the industry. It explains in detail the criminal and civil False Claims Act, the Anti-Kickback Statute, and the Stark Law prohibiting self-referrals. In addition, it describes the new authority given to the government to investigate and prosecute alleged offenses under the Health Insurance Portability and Accountability Act of 1996. Finally, it examines the Balanced Budget Act of 1997 and its effects on the health care industry.

Further, Corporate Fraud Investigations & Compliance Programs details the enforcement initiatives of the Department of Health and Human Services and the Health Care Financing Administration, and points out where the likely target areas for enforcement will be in the future. In addition, it explores the Department of Health and Human Services’ authority to impose penalties, including exclusion from federal health care programs. Finally, this resource provides an excellent discussion of compliance programs, with checklists for creating a program, an analysis of compliance risk issues, such as employee relations problems and accounting practices, and advice on the administration and enforcement of an effective compliance program.

Overall, Corporate Fraud Investigations & Compliance Programs is a valuable resource for anyone interested in effectively handling compliance and enforcement issues. To order a copy of Corporate Fraud Investigations & Compliance Programs, you may contact the publisher at 1-800-831-0758 or www.oceanalaw.com.