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Health Care Fraud Focus

Medicare and Medicaid Providers: Choose Your Vendors Wisely—But Be Sure to Pay Them at Fair Market Value and for Bona Fide Services

Aug 27, 2018


Health care providers will often try to negotiate and receive fair, commercially reasonable business terms with vendors and suppliers, to both better serve their patients and improve their “bottom line.” Yet when it comes to services reimbursed by the government — be it Medicare, Medicaid, or TRICARE — what exactly those terms are and how... Continue Reading…


Are All ‘Medical Necessity’ Determinations Subject to False Claims Act Liability? Opinions May Differ.

Jul 16, 2018


Two federal appellate-court decisions handed down in the past few weeks have generated much speculation about whether “medical necessity” determinations underlying Medicare or Medicaid claims can now be considered “objectively false” — despite conflicting medical-expert opinions — and actionable under the False Claims Act (FCA). The most recent opinion was issued on July 9, 2018,... Continue Reading…


Untimely Physician Certifications for Medicare Home Care Claims – Arguably a Technicality – Vulnerable to False Claims Act Allegations: Sixth Circuit

Jul 12, 2018


On June 11, 2018, the United States Court of Appeals for the Sixth Circuit sustained a complaint against a home health care agency alleging that the agency had violated the False Claims Act (FCA) by submitting numerous claims to the Medicare program, even though the agency had not timely received the requisite physician certifications of the... Continue Reading…



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Antitrust and Financial Services

London court sentences two former traders for Euribor manipulation

Aug 13, 2018


On 19 July 2018, as a result of a prosecution brought by the Serious Fraud Office (SFO), a London court sentenced two former traders, Phillipe Moryoussef and Christian Bittar, to eight years and five years in prison for conspiracy to defraud by manipulation of the ‘Euribor’ interest rate benchmark. It follows similar convictions in relation to ‘Libor’ manipulation in 2015 and 2016.


Related Attorney(s): Vincent Brophy, Tom Bainbridge
Related Practice(s): Antitrust
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UK Payment Systems Regulator to Review Card-acquiring Services

Aug 07, 2018


On 24 July 2018, the UK Payment Systems Regulator (PSR) announced its intention to conduct a market review into card-acquiring services in the UK. The review could involve significant consequences for UK payment card schemes and acquirers in terms of regulatory changes and antitrust sanctions.

 


Related Attorney(s): Vincent Brophy, Tom Bainbridge
Related Practice(s): Antitrust
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FX: Credit Suisse Signals Intention to Contest the European Commission’s Case

May 09, 2018


Manipulation of foreign exchange (FX) benchmarks has been one of the largest and longest-running probes into collusion between banks and related misconduct.


Related Attorney(s): Vincent Brophy, Tom Bainbridge
Related Practice(s): Antitrust, Antitrust & Financial Services, Antitrust Compliance & Counselling, Antitrust Investigations, Antitrust Litigation & Disputes, Merger Clearance
Related Office(s): Brussels, London
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FCPA Advisor

US and UK Regulators Speak Out on Anti-Corruption Enforcement Trends and Priorities

Dec 06, 2016


A number of key trends and priorities in international anti-corruption enforcement emerged last week at the 33rd ACI International Conference on the Foreign Corrupt Practices Act, held November 29 – December 2 outside of Washington, DC. Leading prosecutors and regulators from the US and UK described skyrocketing international law enforcement coordination, announced both “sticks” and “carrots” to encourage self-disclosure and cooperation, and pledged again to hold individuals accountable for anti-corruption violations. Officials from the Department of Justice (DOJ), the Securities and Exchange Commission (SEC), and the UK Serious Fraud Office (SFO) repeatedly emphasized these points in both their prepared remarks and their responses to questions.


Related Attorney(s): J. Robert Duncan, James Treanor
Related Practice(s): FCPA Enforcement and Compliance, White Collar Defense and Investigations
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Paper Tigers: Recent Settlements Show Companies Operating in China Need to Do More to Enforce FCPA Policies

Mar 02, 2016


Amid a recent flurry of Foreign Corrupt Practices Act (“FCPA”) settlements announced by the U.S. Department of Justice (“DOJ”) and U.S. Securities and Exchange Commission (“SEC”) were two settlements relating to the provision of improper gifts, hospitality and travel to Chinese government officials.


Related Attorney(s): James Treanor
Related Practice(s): FCPA Enforcement and Compliance, White Collar Defense and Investigations
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Eleventh Circuit Defines “Instrumentality” Broadly Under the FCPA

May 19, 2014


On May 16, the Court of Appeals for the Eleventh Circuit became the first federal appellate court to define an important element of the Foreign Corrupt Practices Act (“FCPA”) – what constitutes an “instrumentality” of a foreign government and, thus, who is a foreign official. In United States v. Esquenazi,1 a three-judge panel adopted a broad, fact-based definition of that term. Affirming the criminal convictions of both appellants, the court held that, in order to satisfy the statute, an “instrumentality” had to be an entity that both (1) is controlled by a foreign government and (2) performs a function that the foreign government “treats as its own.” The court provided clear guidance to trial judges and juries by setting out the critical elements to be determined when applying the two-pronged test.


Related Attorney(s): Jodi Avergun
Related Practice(s): FCPA Enforcement and Compliance
Related Office(s): New York
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Women in the City Program

Update - February 2017

Feb 14, 2017


What skills do women need to be successful leaders in the Fintech and alternative finance industry?

Can emerging companies offer an opportunity for women to do something different? Can technology revolutionise conventional financial services? These and other questions were debated by a panel of high profile leaders from the European FinTech and alternative finance industry to discuss opportunities and challenges for women in this growing area as part of Cadwalader’s Women in the City Programme, a series of seminars designed to inspire more women to take leadership roles in their organisations by offering open dialogue, useful insights and practical guidance.


Related Attorney(s): Jeremiah Wagner
Related Office(s): London
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Update - October 2016

Oct 14, 2016


How can more women be encouraged into funds?

This question was debated by a panel of women leaders in the investment fund industry at Cadwalader's second Women in the City debate.  The programme of discussions is designed to inspire more women to take leadership roles in their organisations by offering open dialogue, useful insights and practical guidance. Cadwalader hosted a large group of clients and colleagues over breakfast for a very lively panel discussion entitled "Women in Investment Funds: A Fundamental Advantage: Building Female Talent in the Investment Management Sector".


Related Attorney(s): Ingrid Bagby
Related Office(s): London
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Update - August 2016

Aug 04, 2016


What skills do women need to be successful leaders?

This question was debated by a panel of high profile female leaders at the recent launch of Cadwalader's Women in the City Programme, a series of seminars designed to inspire more women to take leadership roles in their organisations by offering open dialogue, useful insights and practical guidance.


Related Attorney(s): Gregory Petrick
Related Office(s): London
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CadwaladerSpotlight

October 4: CREFC CRE CLO Conference | New York City

Cadwalader partners Stuart Goldstein and Jeffrey Rotblat will speak at this key industry event.

Cadwalader's research and intelligence platform provides analysis on changes in U.S. financial regulation. Subscribers receive a daily newsletter interpreting new laws, rules and enforcement actions that impact financial institutions.