Facing any type of legal issue can be extremely serious. It often involves your family, your financial well-being, your freedom, your future or the vitality of your business. Unfortunately, for most people, understanding how to protect themselves feels like a guessing game. Regardless of your legal matter, you always have rights. However, exercising those rights is only as effective as your legal representation.
Fraud, in its basic definition, is A false representation of a matter of fact whether by words or by conduct, by false or misleading allegations, or by concealment of what should have been disclosed that deceives and is intended to deceive another so that the individual will act upon it to her or his legal injury. A person who uses deceit to take from another is engaged in fraud.
Fraud costs the United States billions of dollars every year, whether through lost tax revenue, corporate malfeasance, deceptive accounting practices or through corruption. Many places in the world today are unsafe in which to do business because of the persistence and ubiquity of these crimes.
Our firm, with its experienced Attorneys and Certified Fraud Examiners, stands ready to assist you in the detection and determination of fraudulent activity and if it is found and prosecution ensues, ready to stand with you to defend your rights.
The Foreign Corrupt Practices Act (“FCPA”) makes it unlawful for a U.S. person, and certain foreign issuers of securities, to make a corrupt payment to a foreign official for the purpose of obtaining or retaining business for or with, or directing business to, any person. The anti-bribery provisions also apply to foreign firms and any person who takes an act in furtherance of making a corrupt payment within the United States.
The FCPA also requires companies that are publicly traded in the United States to maintain internal accounting controls so that their transactions are accurately reflected. These “books and records” provisions are a separate offense but were designed to be read with the anti-bribery provisions.
The FCPA applies to any individual, including the U.S. parent corporation of a foreign subsidiary, if the parent authorized the activity in question. For the payment to be corrupt, it must be intended to induce the recipient to misuse his official position to direct business wrongfully. The payment need not succeed, and a violation may occur by simply offering to make a payment. A payment includes money or anything of value.
Health Care Fraud focuses on whether the medical provider knowingly defrauded a health care benefit program by submitting claims for services or products that were never provided, or rendered services that were not medically necessary. Often times, federal and state agencies act jointly to ferret out fraudulently submitted claims by investigating and auditing doctors, ambulance companies, pharmacists, hospitals, clinics and other providers doing who are doing business with healthcare insurers. A healthcare benefit program includes the government programs of Medicare (federal) and Medicaid (state).
Criminal prosecutions may result from an administrative audit of the provider. For example, a Medicare auditor may look closely at a sample of patients and determine that their billed treatment was not medically necessary. An unsuccessful review could trigger a further inquiry, an appeal process, suspension of the provider’s Medicare or Medicaid number, reimbursement for loss, or even criminal prosecution.
A provider receiving an audit letter or who is indicted for Health Care Fraud should immediately consult with counsel adept at investigating and advising medical providers. A successful administrative review could remove the provider from the government’s radar, thus it is critical to follow the administrative process.
An insurance beneficiary may commit insurance fraud by making a false statement to obtain some insurance benefit or advantage to which the beneficiary is not otherwise entitled. The alleged fraud could involve something serious, like arson or a staged car accident. At times, the alleged conduct could more minor, involving a mistake in calculating loss from a flood.
Insurance Fraud may also be perpetuated by the insurer. The FBI estimates that $40 billion is misappropriated annually through several insurance-related schemes including premium diversion (collecting premiums but not providing the sums to the underwriter); not paying valid claims; fee churning (the repeated taking of commissions for reinsurance agreements that reduce the premium to nil); and misappropriation of workers compensation insurance.
Health Care Fraud News & Information
We understand what is at stake for our clients. If convicted of Medicare fraud, they may face criminal penalties and loss of medical licensure. That is why we take the cases as seriously as our clients do and work tirelessly to resolve the matter outside of a trial.
We are equipped to help you fight a range of Medicare fraud charges, including:
In order for the government to make its case and secure a conviction, it must prove the Medicare fraud was intentional and not an unintentional mistake. So if you simply did not understand the Medicare coding/billing requirements and accidentally made an error, the law is on your side. However, that will not stop the government from trying to prove otherwise. With your freedom, your professional practice, and your future on the line, it is important to have a skilled legal team on your side.
“Internet Fraud” generally refers to any type of fraud scheme that uses e-mails, online advertisements, or websites to solicit prospective victims, conduct fraudulent transactions, or transmit proceeds from the scheme to financial institutions. The schemes may touch persons worldwide in a matter of seconds, but require the rectitude and steadiness of experienced white-collar defense attorneys who have spent decades investigating, defending, and prosecuting fraud.
Common Types of Internet Fraud
Money laundering is the practice of engaging in a financial transaction to conceal the source, amount, identity, or destination of the ill-gotten money. Penalties for this type of behavior are severe. In addition, with the new Anti-Terrorism laws, money laundering accusations can also lead to possible prosecution for terrorism-related charges.
Breaking Down Money Laundering
Federal and state governments have made prosecuting mortgage fraud a significant priority. In part, the number of investigations has intensified due to the impact that the housing market has on the nation’s economy and its financial institutions, but also because federally insured financial institutions have increased their reports of fraud to the FBI.
Mortgage fraud schemes generally involve a material misstatement, misrepresentation, or omission relating to a property that is presented to and relied upon by the lender or insurer in making a decision whether to fund, purchase or insure the loan. In 80 percent of federal cases, the “scheme” involves an agreement between an industry insider or insiders – an appraiser, underwriter, mortgage broker, or banker – to siphon money or equity out of a transaction. A critical fact in mortgage fraud cases is whether the fraudulent statement is “material”; whether the lender or insurer knew about the falsehood; and whether the lender or insurer conducted a diligent review before executing its decision.
Financial Institution / Mortgage Fraud
The Rise Of Mortgage Fraud: How To Spot Common Schemes
Increasingly, contract disputes are resulting in criminal charges, specifically, as they relate to procurement fraud allegations levied against contractors and employees who work for government contractors. If you, or your company, is under investigation for possible procurement fraud, the time to contact a criminal defense attorney knowledgeable in this area is now.
Fighting Federal Procurement Fraud
Former Navy Senior Chief Sentenced in Procurement Fraud Scheme
The Racketeer Influenced and Corrupt Organizations (“RICO”) Act prohibits a criminal enterprise’s use of racketeering to manipulate the marketplace or affect interstate commerce. Racketeering, for purposes of the Act, refers to a pattern of illegal activities carried out by a member of the enterprise. To fall under RICO, there must be a pattern of illegal activity. Under the Act, a pattern is established when a person commits two of the Act’s prohibited activities. There are 35 prohibited activities, including include bribery, extortion, violent crimes such as murder and kidnapping, arson, and obstruction of justice. Our attorneys are experienced in representing individuals and companies for these very serious matters.
Racketeer Influenced and Corrupt Organizations (RICO) Law
Wire fraud makes it a federal crime for any person to use interstate wires – any electronic communication, including the telephone, fax, email, internet, television, and radio – in a scheme to defraud another.
Mail fraud makes it a crime to use any public or private interstate mail carrier or service to carry out a scheme to defraud someone. Fraud is the knowing misrepresentation, omission, or misstatement of a material fact to induce another to act to his detriment.
The Sarbanes-Oxley Act (“SOX”) sets forth accounting rules and required disclosures for publicly traded domestic and foreign companies doing business in the United States and private companies preparing to become public.
SOX compliance requires applicable companies to establish an accounting framework that produces financial reports that rely on verifiable data. The data cannot be revised without documenting the change, the person who made it, the reason, and the date. Additionally, SOX requires companies to disclose material changes to their financial conditions and operations in an easily understandable format. Finally, companies must keep and maintain business records for five years. The CEO and CFO are responsible for the accuracy of each financial report submitted to the Securities and Exchange Commission (“SEC”) and can be held criminally liable under SOX for making false or inaccurate reports.
It is vital to have competent legal counsel when charged with SOX violations or even if under investigation for SOX violations.
The Laws That Govern the Securities Industry
Immigration fraud is the misuse of the immigration system to bring noncitizens to the United States. This includes: the filing of false paperwork, the presentation of false evidence, “fake marriages,” improper employment of noncitizens, fail to correctly complete and maintain I-9 records, and making misstatements on immigration forms. These are serious crimes. Not only can the person be charged with these felonies, but if the person is a non-citizen, they can be removed from the United States.
Our attorneys, skilled in both criminal defense and immigration, can defend your rights when accused of these serious crimes. Remember: it is critical to have an attorney who is skilled in both criminal defense and immigration when working with these matters.
Identity & Benefit Fraud Information
The criminal prosecution of a corporation can have serious consequences. Not only can employees and officers be held criminally liable, but a corporation that is prosecuted for fraud or corruption may lose the ability to enter into contracts with the United States. Additional consequences can include:
Corporations may be liable for the criminal acts of employees if two prongs are met: the employee’s actions were within the scope of her authority and the conduct benefits the corporation in some way. To be clear, if there is a reasonable relationship between the employee’s action and her corporate responsibilities, then the corporation could be liable for the employee’s conduct.
Additionally, under the legal principle of accomplice liability, a supervisor who turns a “blind eye” to criminal actions may be liable. Similarly, under the responsible corporate officer doctrine, an officer that fails to take remedial measures to curb an employee’s illegal conduct may also be prosecuted, even if the officer did not encourage or participate in the illegal acts.
Even if the Federal or State Government is now “knocking on your door,” it is imperative to get qualified criminal defense counsel immediately. Corporate malfeasance must be thoroughly examined and hard decisions will need to be made by all parties. The right criminal defense counsel can stand by a company, and the workers and officers with that company, to make certain your rights are protected.
It is critical for a corporation to understand the consequences of criminal prosecution so that it survives to continue conducting business.
If your corporation faces criminal prosecution, please contact The Tausk Law Firm for help and legal protection.
DOJ Stresses Individual Accountability in New “Yates Memo”
The practice of law is difficult. From time to time attorneys will find themselves in the position of having our clients become our adversaries. This is a difficult time and it is critical to turn to someone with a background in grievance defense. Let us help you.
Gene Tausk served for six years on the Grievance Committee of the State Bar of Texas. For three of those years, he was a Panel Chair. He understands the complexities AND IMPORTANCE of having your license properly defended. When your license is on the line, it is important to get representation who understands not only what you are going through but has the experience and ability to properly defend you and your bar card.
When your law license is threatened, turn to an attorney who can assist you. Contact our Firm.
Gene has vast experience in criminal appeals and is very familiar with the overall process. It's is critical for a client to select an attorney that has worked many times with these types of cases.
Our firm is committed to protecting the rights of those from the business community suspected of fraud. Penalties can be very severe so these charges must be taken seriously and vigorously defended.
Employers can face severe penalties for not having proper I-9 documentation for workers. With recent policy changes it is more critical than ever that you are prepared to defend your business when going through an audit.
Gene P. Tausk hosts the ‘Fraud and White Collar Crime’ podcast. New episodes are available twice a month. The podcast is available on:
