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 fraud.
Our firm, with its experienced Attorneys and Certified Fraud Examiners, stand ready to assist you in the detection and determination of fraud and, if fraud is found and prosecution ensues, ready to stand with you to defend your rights.
Fraud, and fraud prosecution, can take many forms, including:
Foreign Corrupt Practices Act:
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 antibribery 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 antibribery provisions.
The FCPA applies to any individual, including the U.S. parent corporation of a foreign subsidiary, if 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:
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 health care insurers. A health care benefit program includes the government programs of Medicare (federal) and Medicaid (state).
Criminal prosecutions may be blossom 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 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.
“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.
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.
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 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.
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 an criminal defense attorney knowledgeable in this area is now.
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 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.
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. A 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.
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 noncitizen, 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.