Data Driven Compliance: The Failure to Prevent Fraud Offense: Insights for US General Counsels with Mike DeBernardis
The State of Healthcare Enforcement
Daily Compliance News: August 21, 2025, The Fabricated Evidence Edition
Data Driven Compliance – James Tillen on the Importance of Cross-Functional Collaboration in Complying with the FTPF Offense
2 Gurus Talk Compliance: Episode 57 — The Tom on His Highhorse Edition
Data Driven Compliance: Understanding the ECCTA and Its Impact with Jonathan Armstrong
10 For 10: Top Compliance Stories For the Week Ending, August 2, 2025
Data Driven Compliance: Understanding the ECCTA and Its Impact on Fraud Prevention with Vince Walden
Everything Compliance: Episode 158, The No to Corruption in Ukraine Edition
Daily Compliance News: July 31, 2025. The Forgotten Generation Edition
Understanding BBB Ratings: Building Trust and Mitigating Risks — Regulatory Oversight Podcast
Episode 379 -- Update on False Claims Act and Customs Evasion Liability
Data Driven Compliance: Understanding the UK’s New Failure to Prevent Fraud Offense with Sam Tate
Everything Compliance: Episode 157, The Q2 2025 Great Women in Compliance Edition
Daily Compliance News: July 22, 2025, The I-9 Hell Edition
Compliance Tip of the Day: Avoiding CCO Liability
2 Gurus Talk Compliance: Episode 55 – The From Worse to Worser Edition
Daily Compliance News: July 17, 2025, The COSO Yanked Edition
Wire Fraud Litigants Beware: Fourth Circuit Ruling Protects the Banks — The Consumer Finance Podcast
Compliance into the Weeds: Agentic Misalignment and AI Ethics: Analyzing AI Behavior Under Pressure
Effective August 1, 2025, Anthem will implement a new claims-editing process that adjusts payments for Medicare Advantage (MA) claims based on an undisclosed, customized chargemaster table. The announcement identifies claims...more
Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more
On April 30, the Federal Bureau of Investigation (FBI) released a Public Service Announcement warning consumers about fraudulent discount medical scams. These scams typically involve deceptive offers for health insurance...more
Attorneys from Ropes & Gray attended the Medicarians Conference from March 31 to April 2, a premier event for Medicare Advantage (MA) and other health insurance brokers, agents, and distribution arms, as well as regional and...more
On December 23, 2024, various Aetna affiliates (referred to hereafter as Aetna) filed suit against Radiology Partners, Inc., a national, private-equity-backed radiology group, alleging that Radiology Partners defrauded the...more
Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as...more
The Mitchell Williams Insurance Regulatory team of attorneys recently attended the National Association of Insurance Commissioners (NAIC) Fall 2024 National Meeting which was held in Denver, Colorado. We have prepared a...more
The Mitchell Williams Insurance Regulatory team of lawyers recently attended the National Association of Insurance Commissioners (NAIC) 2023 Summer National Meeting which was held in Seattle, Washington. We have prepared a...more
The nation’s biggest health insurers are gaming a giant program to provide health coverage to seniors, exploiting the privatization of Medicare Advantage plans to rake in profits with schemes that have drawn fire from...more
SIU stands for Special Investigation Unit, and nearly all insurance companies have one, especially health insurers. SIUs exist to investigate complaints of fraud, waste or abuse, and train claims personnel to recognize and...more
The growth of direct-to-consumer DNA kits is a big deal with significant ramifications for the life insurance industry. Direct-to-consumer DNA kits, commonly used to track ancestry roots, increasingly allow individuals to...more
We’ve talked a fair amount about the switch to chip & pin card systems over the past few years. But how about a lack of cards altogether? Because that’s what the banks have in mind....more
When was the last time your organization reviewed your insurance policies? Not all policies are equal. Many religious organizations are underinsured. Most should have general liability, property, professional liability,...more
In late June, the New York Court of Appeals affirmed a trial court ruling that there was no coverage for a health insurance company policyholder, under a “Computer Systems Fraud” rider issued by its insurer, for an underlying...more