Martin Biegelman Presents at the SCCE Basic Compliance & Ethics Academy in Seattle, WA

Martin Biegelman Presents at the SCCE Basic Compliance & Ethics Academy in Seattle, WA

SunHawk Consulting, LLC is excited to announce that Managing Director, Martin Biegelman will be serving as expert faculty during the SCCE Basic Compliance and Ethics Academy on August 5, 2021, in Seattle, WA. Don't miss out on Martin's presentation on Conflicts of Interest! About Martin Biegelman Martin Biegelman, CFE, CCEP Managing Director & Investigations Practice Leader SunHawk Consulting, LLC Martin.Biegelman@SunHawkConsulting.com Martin Biegelman has spent a lifetime detecting, investigating, and preventing fraud and corruption in various leadership roles in law enforcement, consulting, and the corporate sector. His work on behalf of corporate management and boards includes conducting internal investigations, including independent investigations, alleging fraud, corruption, Foreign Corrupt Practices Act violations, conflicts of interest, whistleblower retaliation, and other employee and vendor misconduct. Martin’s work also includes developing, assessing, and enhancing corporate compliance and ethics programs including internal investigative and anti-bribery compliance programs, as well as performing fraud risk assessments. Click Here to view Martin's full bio SunHawk Consulting and its compliance consultants and advisors are highly experienced in conducting independent investigations with outside counsel. Their investigative experience includes financial accounting fraud, conflicts of interest, inappropriate personal relationships, harassment, whistleblower retaliation, and other organizational code of conduct violations. Our subject matter experts can provide insight into your specific risk and other compliance program needs. We are happy to have a discussion with you and determine how we can possibly assist you in responding to and mitigating risk.

SunHawk's HHS OIG Audit Summary Reports - Provider and Payer July 2021 Update

SunHawk's HHS OIG Audit Summary Reports - Provider and Payer July 2021 Update

HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The findings and recommendations provided herein are extracted from the specific audits included in this report and referenced by their respective report numbers at the end of each abstract. SunHawk’s reports summarize completed audits and evaluations over the last 12 months and sorts relevant audits into the Provider and Payer categories. For the PROVIDER-FOCUSED Completed Audit Summary Report CICK HERE For the PAYER-FOCUSED Completed Audit Summary Report CLICK HERE SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn. If additional information would make this report more valuable to you, please reach out and give us your thoughts. Kimulet.Winzer@SunHawkConsulting.com James.Rose@SunHawkConsulting.com Jan.Elezian@SunHawkConsulting.com Jim@SunHawkConsulting.com SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

SunHawk's OIG Work Plan July 2021 Update

SunHawk's OIG Work Plan July 2021 Update

HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The OIG Work Plan sets forth various projects, including OIG audits and evaluations, that are underway or planned to be addressed during the fiscal year and beyond. SunHawk's OIG Work Plan Summary Report summarizes currently active Work Plan items and sorts relevant Work Plans items into Provider and Payer categories. CLICK HERE to download the OIG Work Plan Summary Report for PROVIDERS CLICK HERE to download the OIG Work Plan Summary Report for PAYERS SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn.

If additional information would make this report more valuable to you, please reach out and give us your thoughts.

Jan.Elezian@SunHawkConsulting.com Kimulet.Winzer@SunHawkConsulting.com
Jim@SunHawkConsulting.com

SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

SunHawk Consulting celebrates its 4 Year Anniversary!

SunHawk Consulting celebrates its 4 Year Anniversary!

SunHawk Consulting, LLC is proud to mark our 4 Year Anniversary. We want to thank all of you for being a part of SunHawk Consulting’s early success. In May of this year, we launched our Investigations Practice led by Martin Biegelman, CFE, CCEP, who has spent his 45-year career detecting, investigating, and preventing fraud and corruption in leadership roles in law enforcement, consulting, and the corporate sector. Martin is joined by James Rough, CFE, CHC, CCEP, Juliette Gust, CFE, Douglas Small, CEP, CFE, CFF, Jerrold Bamel, Peter Sullivan, Robert M. Weiner, Esq., and Michael Kotch, CFE, CMAS, CFCE who have long careers and significant experience conducting forensic investigations of fraud, FCPA, and other corporate misconduct. Our experts have been honored to present at several industry conferences over the past year, including the HCCA's 2020 Indianapolis Regional, 2020 Scottsdale Regional, 2020 Louisville Regional, 2021 Managed Care Conference, and 2021 HCCA Compliance Institute, to name a few. Also through our Risk & Compliance blog series, our experts have had the opportunity to share their knowledge, on risk and compliance issues. We look forward to the opportunity to share our ideas with even more great industry thought-leaders in the coming years. Over the last four years the SunHawk Team has built many internal and external proprietary tools including HIPAA CheckTM, Compliance CheckTM, and Compliance Effectiveness Tool. In June of 2020, we released our first HHS OIG Monthly Report - The HHS OIG Completed Audit Summary. Since then, we have launched our free monthly report newsletter which includes three additional reports, including our HHS OIG Work Plan Summary, HHS OIG Corporate Integrity Agreement Summary, and HHS OIG National Institutes of Health Summary. Our fifth free monthly report is currently in development which tracks enforcement by HHS, Office of Civil Rights. If you are interested in receiving updates to these reports - as well as any new reports - monthly, you can subscribe to our newsletter HERE. To all our clients, consultants, and friends – we thank you for your continued commitment to SunHawk and look forward to another successful year.

The New Normal in Higher Education Risk: Why Institutions Need Compliance Program Assessments

The New Normal in Higher Education Risk: Why Institutions Need Compliance Program Assessments

If a college or university has not conducted a recent assessment of its higher education compliance and research program, the pressing question is why not? Worse yet would be if the institution has never conducted such an assessment. Given the requirements, complexities, and multitude of risks that colleges and universities face, a comprehensive compliance program evaluation is critical. The existing and emerging risks should place every institution on notice that their compliance program must be up to the challenge of the new normal and new standards in higher education. It has been said that higher education faces more risks than most corporations. There are numerous program requirements and associated risk areas including Title IX[i], Clery Act[ii], research and grant compliance, Greek life oversight, student-athlete recruitment, campus and student security, privacy, export controls, and others. These are now joined by the newer but just as serious challenges that include campus policing, foreign funding of higher education, Foreign Corrupt Practices Act compliance, as well as the exponential proliferation of cyberattacks with malware and ransomware. Colleges and universities do not have a choice of which of these risks to address as all are critical. Headline-making scandals and offenses involving higher education have become all too common in recent years. Sexual assaults, cheating, fraudulent admissions practices, college basketball corruption cases, hazing rituals resulting in tragedy, and other transgressions resulted in financial, litigation, and reputational risk. All these risks place colleges and universities in jeopardy. The varied aspects of higher education make it imperative to maintain an effective compliance program that follows the Federal Sentencing Guidelines and other leading practices. Yet, even the best university compliance program on paper can be exposed as ineffective without leadership support and too much control by those who foster entitlement and believe the rules do not apply to them. Take the example of Penn State University’s football program that decided not to participate in some of the university’s compliance requirements including Clery Act compliance. “The football program, in particular, opted out of most of the University’s Clery Act, sexual abuse awareness and summer camp procedures training,” according to an investigative report on the Gerald Sandusky child sexual abuse inquiry issued by former FBI Director Louis Freeh and his law firm.[iii] “The Athletic Department was perceived by many in the Penn State community as ‘an island,’ where staff members lived by their own rules.”[iv] Clearly, Penn State’s compliance program at that time was ineffective. The Federal Sentencing Guidelines Manual reinforces that effective compliance and ethics programs “promote an organizational culture that encourages ethical conduct and a commitment to compliance to the law.”[v] The Federal Sentencing Guidelines are not just for corporations; they are just as important for higher education. The Department of Justice’s Principles of Federal Prosecution of Business Organizations considers the “adequacy and effectiveness of the organization’s compliance program at the time of the offense….. and the corporation’s remedial efforts.”[vi] The DOJ’s Principles further discuss that compliance programs must be “truly effective” rather than just “paper programs,” and whether the program is “well-designed, applied earnestly and in good faith.”[vii] The true test is whether the compliance program actually works as intended on a daily basis. This brings us back to the premise of this article and the necessity to assess the compliance programs of educational institutions. The article is not about the actual process of conducting a compliance program assessment but to highlight the importance of conducting ongoing compliance program assessments. It is not just a best practice but a continuous improvement tool. The DOJ’s Evaluation of Corporate Compliance Programs, updated June 2020, opined that a “hallmark of an effective compliance program is its capacity to improve and evolve,” and whether an organization “has engaged in meaningful efforts to review its compliance program and ensure that it is not stale.”[viii] It is not enough to create a formal compliance program and think it is finished. Colleges and universities need to periodically assess the effectiveness of the program and modify and enhance it as appropriate based on that assessment. It is just as important to assess the compliance program’s ability to respond to emerging risk issues that are making headlines today and will continue to in the future. This article will focus on three of the most current and pressing risks facing higher education, but certainly, they are not the only ones. All risk issues need to be included in the periodic program assessments. Campus Policing in the Aftermath of the George Floyd Case The events of the last year are having profound implications for policing. The murder of George Floyd and the subsequent conviction of the culpable police officer will fundamentally change American policing and that includes campus policing. Good cops can no longer stand by and do nothing when bad cops brutalize and murder the very citizens they are sworn to protect and serve. The infamous blue wall of silence that protects wrongdoers needs to be toppled. There are signs of cracks in that wall. The trial of former police officer Derrick Chauvin in the George Floyd case included the clear and convincing testimony of police officers that contributed to the jury finding the defendant guilty on all counts. As a result of these changing times, campus police departments need to meet the challenge of the new normal in higher education risk and this evolving risk. “There are more than 4,000 campus police departments across the country that employ nearly 32,000 campus police officers.”[ix] They generally mirror the police departments in their surrounding communities often with similar policies and procedures, and the same issues. Take the example of the University of Cincinnati police officer who shot and killed a motorist during an off-campus traffic stop on July 19, 2015, over an alleged missing license tag. “The shooting sparked a media firestorm in the wake of a string of highly publicized police shootings throughout the United States, many involving white police officers and unarmed, African American male victims.”[x] The University of Cincinnati paid the family of the deceased individual $4.85 million. The police officer was fired and indicted for murder. After two juries deadlocked, the indictment was dismissed.[xi] The University of Cincinnati commissioned a consulting firm to investigate the tragic incident. The subsequent report stated that “Working as a police officer on a university campus and providing safety and security to faculty, students, and visitors is distinctly different from patrolling racially, ethnically and socio-economically diverse urban neighborhoods.”[xii] The report further stated that “Police departments should emphasize their strengths and recognize inherent and mission-based limitations.”[xiii] Colleges and universities should determine if their campus police should be limited to on-campus activities and whether their officers have the training and skills to intercede off-campus. Increased transparency and responsibility are needed by campus police departments. Colleges “can close loopholes that would shield campus police from accountability as employees of the institution and publish campus police department handbooks and policy documents that explain their procedures and tactics.”[xiv] Officer accountability is vital to the public’s trust and faith in a police officer. The legal doctrine of qualified immunity provides police officers and other government officials immunity from civil suits for their actions in the performance of their official functions, providing their actions are legal and reasonable. The George Floyd Justice Policing Act of 2021 currently before Congress would do away with qualified immunity for police officers. Whether or not this act is passed, higher education must confront this issue. Has your institution taken a stance on qualified immunity and whether it needs to be changed? Does your campus police department and/or the local prosecutors that take their cases maintain a Brady List? A Brady List is a compilation of known police misconduct that is required by law to be turned over to defendants and their counsel as inculpatory evidence to impeach the testimony of implicated police officers. The Brady List requirement comes from the 1963 Supreme Court case of Brady v. Maryland that requires prosecutors to turn over evidence that would prove the innocence of a defendant or impeach the credibility of government witnesses including police officers. There is no national police misconduct registry and not all police departments or prosecutors maintain such lists. In today’s environment, every campus police department should maintain a Brady List of its officers who have been involved in misconduct. Does your campus police department or university general counsel’s office maintain a Brady List? It is also important to know if the officers that campus police departments hire have been subjected to discipline for misconduct in prior law enforcement positions. The vast majority of police officers and other law enforcement professionals are women and men of integrity and honor their oath of service, their departments, and their communities each and every day. It is the very few rogue officers who get the spotlight and dishonor their badges. They are the ones that must be identified and removed from police departments, or never hired in the first place. Do you know if the campus police officers you hire have previously been fired or forced to resign due to misconduct during tenures at other police departments? Colleges and universities need to review and revise their use of force policies based on the troubling deadly force used against George Floyd and other notorious headline-grabbing cases. If a campus police department does not include de-escalation training, it must now be included in policies and training. Just as important, train your campus police officers to intercede when another officer is violating policy and the law including excessive use of force. Make it a requirement for campus police officers to step forward and not stand back when they witness wrongdoing by other officers. Had the three other Minneapolis police officers present during the arrest of George Floyd gone horribly wrong and stopped the actions of Derrick Chauvin, a senseless murder would have been averted. Does your university have a de-escalation policy and related training for campus police officers? The Chauvin prosecution was aided in part by the police body cameras worn by officers on the scene. Body cameras are becoming the norm for police departments today and it should be no different for campus police departments. In fact, many campus police departments have instituted body camera policies for their officers. An Arizona State University professor who has studied the use of body cameras “believes that the prevalence of body cameras among college police forces is rooted in their tendency to copy other agencies.”[xv] All colleges and universities should institute mandatory police body cameras and related policies and procedures including when campus police officers are to activate and de-activate bodycams. Officers need to be held accountable if their cameras are purposely not activated in critical situations or if they are turned off inappropriately. In addition, there should be a policy for public disclosure of bodycam footage for incidents with a significant public need to know. Does your institution of higher learning require body cameras for its police officers along with associated policies and procedures? There has been a troubling trend to militarize police departments with obsolete and excess military equipment provided by the U.S. Department of Defense. This tendency has extended to campus police with “at least 124 campus police departments” receiving this equipment.[xvi] For example, “Ohio State University obtained a mine-resistant, ambush-protected vehicle” and the “University of Central Florida acquired a grenade launcher and repurposed it to fire tear gas.”[xvii] The militarization of police departments has been found to increase violent behavior in police according to one study.[xviii] Has your college or university been the recipient of military hardware? Have you determined if there is more harm than good to having this military equipment on campus and the message it sends to students, faculty, the community, and others? Colleges and universities need vigorous campus police internal affairs units to appropriately respond to complaints about police behavior. Now more than ever, the police are under scrutiny from the public, and ensuring trust is paramount. Transparency is needed to build and maintain that trust. For example, the Cornell University Police Department website has a link to its Internal Affairs unit information page. There is information on how to submit a citizen’s complaint, the progress of the investigation, and an Annual Internal Affairs Summary that provides the number of complaints, the types of allegations, the disposition of the case, corrective action, and trends. This is a leading practice and should be included in your compliance program assessment. Does your university have similar transparency about the operations of its campus police department? In addition, make sure to assess the culture of your campus police department. Is the blue wall of silence present? Is racial profiling in existence? Are your campus police leaders and officers open to change? Are they representative of your campus and community with respect to diversity and inclusion? Have you used culture surveys and focus groups to obtain feedback from officers, students, faculty, staff, and institution leadership? Higher education needs to include cultural competence to “provide vital insight into understanding how communication and interaction between citizens and police might be enhanced.”[xix] Transformative changes are coming to American law enforcement and institutions of higher learning can be at the forefront of that shift with their campus police departments. The campus policing elements discussed above do not comprise an all-inclusive list to review in your program assessment. So, if you have not conducted a higher education compliance program assessment that includes your campus police department, you need to put that on your compliance to-do list. If you do nothing else in response to the recommendations from this article, an assessment of your campus police department is an absolute necessity. Foreign Government Financial Influence If colleges and universities did not have enough to worry about, now there is added risk from foreign government influence, failing to report hundreds of millions of dollars in gifts and contracts from foreign adversaries, violations of the federal Foreign Agents Registration Act, violations of the Higher Education Act of 1965, and other related national security threats. While this may sound like the plot for a Hollywood movie, it is not fiction but a new reality for higher education. The United States Department of Education reported that “fewer than 300 of the approximately 6,000 U.S. colleges and universities report receiving foreign money each year.”[xx] Investigations by the Department of Education, the General Accounting Office, and Congress reported that “colleges and universities significantly underreport their foreign gifts and contracts.”[xxi] One Ivy League institution is under investigation for allegedly failing to report $375 million from foreign sources. Another Ivy League institution’s department chair was indicted for lying about receiving money from the Chinese government for his research efforts. These and many more such issues call into question the controls and compliance that colleges and universities must have in place. There have been several converging factors for the focus on the extent and impact of foreign government financial influence on higher education. In 2018, the U.S. Department of Justice announced its China Initiative to counter the Chinese government’s efforts “to acquire the intellectual property and technologies of the world and to capture the emerging high-technology industries that will drive future economic growth.”[xxii] The China Initiative focuses on prosecuting “those engaged in trade secret theft, hacking, and economic espionage” and “external threats through foreign direct investment.”[xxiii] This includes higher education. In 2019, the U.S. Department of Education increased its investigations of higher education institutions that received foreign funding but did not disclose the funding as required by an obscure section of the Higher Education Act of 1965. Section 117 of this Act requires institutions of higher learning to maintain financial transparency by reporting contracts and gifts from a foreign source in the amount of $250,000 or more in a given calendar year. “If colleges and universities are accepting foreign money and gifts, their students, donors, and taxpayers need to know how much and from whom. Moreover, it’s what the law requires.”[xxiv] Colleges and universities were now in the government’s crosshairs. The Department of Education’s investigations targeted a who’s who of universities including Harvard, Yale, Cornell, Georgetown, MIT, Stanford, and Auburn. The investigations have borne fruit. The Department of Education reported that since July 2019, $6.5 billion in previously undisclosed foreign funding has been disclosed by colleges and universities. This may be the tip of the iceberg. The Department of Education has reported that “fewer than 3 percent of 3,700 higher education institutions that receive foreign funding reported receiving foreign gifts or contracts exceeding $250,000.”[xxv] In a demonstration of the seriousness of the government’s probe of foreign funding of higher education, the Department of Education sent demand letters to Harvard and Yale requesting documentation related to gifts and contracts from foreign sources. The publicly available letters also requested information about the existence of institutional controls and audit practices to ensure appropriate reporting. An attorney who represents academic institutions in government enforcement matters opined on the government’s aggressiveness that by “posting these kinds of open letters on a website and making a big splash about it, that’s really an effort by the government to send a message -- and that message is supposed to be heard throughout academia.”[xxvi] Congress is also concerned about foreign funding of higher education and is considering bipartisan legislation to limit foreign economic influence, especially that of China. The bill “would give federal officials new authority to examine foreign gifts and contracts to U.S. universities valued at more than $1 million and that relate to the development of critical technologies.’”[xxvii] Another provision of the bill would lower the existing foreign funding amount for reporting to the Department of Education. The bill “would require universities to report gifts or contracts valued above $50,000 down from the current $250,000 threshold.”[xxviii] In addition to the federal government’s investigation, states are also considering legislation to crack down on foreign funding of higher education and especially Chinese government influence. Florida has passed legislation that would force institutions of higher education ”to disclose contracts with and donations and gifts received from China, Cuba, Iran, North Korea, Russia, Syria, or Venezuela.”[xxix] Any foreign funding over $50,000 from these countries must be disclosed to Florida authorities. Higher education needs to respond to this new challenge with appropriate compliance initiatives. In one example of an appropriate reaction, the University of California’s Office of Ethics, Compliance and Audit Services (“ECAS”) created a Foreign Influence Compliance Strategy. The ECAS “designed a series of compliance measures to address many of the national concerns related to foreign influence while ensuring our university’s commitment to fundamental research and the principles of academic freedom.”[xxx] Their compliance plan includes four broad “categories: (1) A Training and Awareness Program, (2) Compliance Assessments, (3) Systemwide Audits, and (4) Investigative Protocols, Tracking, and Monitoring.”[xxxi] Communication and awareness are important aspects of the University of California’s compliance plan. This includes systemwide webinars and infographics designed to educate the academic community about the government’s strong enforcement stance, the relevant laws and rules, the associated potential threats, and the importance of compliance. One infographic shows specific behaviors that violate policies and laws, as well as the potential impacts of such behavior. The plan includes frequently asked questions and other information to provide an understanding of the issues and the risk for the University of California. Other institutions of higher education have created similar foreign influence compliance plans including Harvard, Stanford, and Penn State. My question is: has your university responded to the threat of undue foreign influence with an assessment of the risk and the creation of an effective compliance strategy and plan? Foreign Corrupt Practices Act and Anti-Corruption Compliance The Foreign Corrupt Practices Act (“FCPA”) is the U.S. federal statute that outlaws the payment of bribes to foreign government officials to obtain or retain business. There have been numerous prosecutions of corporations and individuals in the last 15 years for violations of the FCPA. Colleges and universities with international operations face the same risk of corruption and bribery. International operations that pose this risk include global campuses, students or faculty overseas, interactions with foreign institutions and governments, and contracting with third parties to recruit foreign students and faculty. It makes no difference if a college, university, or research institution is public or private, large or small; they all need to comply with the FCPA if they have international reach. Many foreign institutions of higher education are government-run, such as in China and India, and corrupt payments may result in FCPA violations as well as in-country bribery violations. Corruption risk may result from paying travel expenses for faculty members at foreign universities that may be in violation of the FCPA and local anti-corruption laws. Third-party risk can result from interactions with joint venture partners, agents, contractors, and representatives as well as from employing friends and relatives of foreign government officials. The great majority of FCPA prosecutions involved the use of third parties to facilitate bribe payments. While higher education has not been a focus of FCPA prosecutions, one case stands out as an example for both the actions of the institution and the resulting favorable outcome. Laureate Education, Inc. (“Laureate”) is a for-profit higher education institution. Laureate determined that a $18 million charitable donation made in Turkey was improperly transferred to a third party and/or a foreign government official at the direction of a senior executive of Laureate. In its disclosure filing to the SEC, Laureate stated that “We believed the donation was encouraged by the Turkish government to further a public project supported by the government and expected that it would enhance the position and ongoing operations of our institution in Turkey.”[xxxii] The institution then executed a textbook example of an appropriate response. Laureate’s audit committee hired outside counsel to conduct an internal investigation. They voluntarily disclosed the investigation results to the DOJ and the SEC and fully cooperated with the government. Laureate took remedial actions that included enhancing internal controls, policies, and procedures, and incorporated best practices. They also terminated the senior executive involved in the charitable donation. In November 2018, the DOJ and the SEC closed the government investigation with no action taken against Laureate. Laureate advised that the “DOJ noted the company's voluntary disclosure, full cooperation, and remediation.”[xxxiii] My question for institutions of higher education is if your anti-corruption compliance program is set up for a similar response to a FCPA allegation? Do you even have anti-corruption policies and procedures? Some university systems have excellent anti-corruption compliance programs. New York University and Duke University are but two examples. Others either have had inadequate or non-existent anti-corruption policies and procedures. In conducting a university compliance program assessment, I learned that the university had little to no understanding of FCPA risk. There were no anti-corruption policies and procedures in existence. This was true despite the university partnering with Chinese universities that included research partnerships, joint ventures, and payment for travel and other expenses for foreign university faculty. My team and I recommended the development and implementation of needed policies and procedures. The Department of Justice is constantly looking for new industries and businesses to investigate for FCPA violations. We may very well see more FCPA investigations of higher education. In addition, there must be compliance with anti-corruption laws in the countries where colleges and universities operate. Here are some scenarios with associated red flags of corruption and bribery to consider: The third-party consultant you hire to recruit students and faculty in Brazil refuses to sign the contract because it contains an anti-corruption certification, a right to audit clause, and a right to terminate clause. You are opening a satellite campus in China because of a partnership with a university there. The foreign university partner point of contact highly suggests that you use a particular consulting firm rather than the one you vetted to obtain the necessary government permits. When you inquire why, he says that it is owned by a good friend whose father is a government official. A university professor from an institution in India has been invited to attend a symposium at your college in New York and you agreed to cover travel costs in accordance with your anti-corruption policy. The professor tells you he wants to fly business class, bring his wife and children, and take a side trip to Disney World and he wants you to pay the costs. So, if you have not conducted a higher education compliance program assessment that includes the risk of corruption and bribery, that should be a priority. In your assessment, the following are some, but not all of the areas you should consider: The existence of an anti-bribery and anti-corruption program, policies, and procedures Ongoing anti-corruption training with scenarios and FAQs Understanding what constitutes a foreign government official or state-owned entity Knowledge of the FCPA and the anti-corruption laws in the countries in which you operate Anti-corruption controls related to third party agreements, permits, licenses, honorariums, charitable contributions, lobbying, expense reimbursement, hiring of friends and relatives of foreign government, and other risk issues Contract controls such as anti-corruption clauses in agreements and contracts, right to audit requirements, and right to terminate Auditing and monitoring, including the red flags of FCPA risk Your compliance program assessment of the corruption and bribery risk should conform to A Resource Guide to the U.S. Foreign Corrupt Practices Act, Second Edition, July 2020, issued by the Department of Justice and the Securities and Exchange Commission. The Resource Guide provides detailed information about the statutory requirements of the FCPA and the “Hallmarks of Effective Compliance Programs” that all organizations, including institutions of higher education, should follow. Universities must also incorporate anti-corruption guidance from the countries they operate in. For example, the UK Bribery Act and Brazil’s Clean Companies Act provide guidance that if implemented, may lessen the imposition of sanctions for corrupt practices. Higher Education Compliance at the Crossroads As a result of my work in assessing, designing, and enhancing compliance programs, I spoke at several higher education conferences discussing the value of an effective higher education compliance program and best practices. I also reinforced the value of conducting ongoing assessments of compliance programs. I heard from more than one university president that unless they were facing headline-making scandals such as what occurred at Penn State, higher education just did not want to spend the money on compliance program assessments. I also learned that there is an overall difference in maturity levels of higher ed compliance programs at some institutions as compared to corporate entities. All too often, the best compliance programs are found at organizations that suffered serious compliance failures. Organizations of all types should not wait for that significant non-compliance event to assess and modify their programs. I have seen examples where university leadership did not communicate values, ethics, or a commitment to a culture of compliance; there was a lack of training for students, faculty, and staff; policies were not reviewed or revised in many years; the hotline did not allow anonymous reporting; internal investigations were conducted by people with little investigation experience; and other instances of needed improvement. One faculty member I interviewed stated that she had not received any compliance training in seven years. Another said she never received sexual harassment awareness training. In yet another example, many of the people interviewed were unaware the university had a chief compliance officer as they never saw or heard from that person. These may be isolated examples but unless you conduct a higher education compliance program assessment, you may never know. There is much that higher education can do to enhance their understanding of their compliance risks. Do you use the government guidance for effective compliance programs in a self-assessment of your university compliance program to identify program strengths, weaknesses, and gaps? Have you read the many reports issued from investigations at Penn State (child sexual abuse), University of Texas (admission practices and allegations of undue influence), University of North Carolina at Chapel Hill (“shadow curriculum” and “paper classes”), Florida State University (sexual assault allegations), University of Cincinnati (off-campus traffic stop and shooting by a campus police officer), and other examples. Many of these reports include recommendations for compliance program enhancement. These reports should be required reading for university presidents, trustees, legal counsel, chief compliance officers, HR, and other leaders. While higher education is facing new risks, long-standing perils continue. In April 2021, prosecutors in Wood County, Ohio announced the indictment of seven students and one non-student at Bowling Green State University for the hazing death of a 20-year-old sophomore.[xxxiv] Subsequently, the university charged the fraternity “with six violations of the student code of conduct, including causing harm to others, hazing and disrupting order or disregarding health and safety with alcohol.”[xxxv] The fraternity’s parent organization commented that “the actions of any individuals found responsible are unacceptable and do not align with [the fraternity’s] values,” and that “The Fraternity’s standards are clear on the conduct expected of members and emphasize treating all people with dignity and respect.”[xxxvi] This is the standard language usually released after hazing tragedies. Still, a young man is dead, and all the written codes, policies, and procedures obviously did not work in practice. The Ohio Attorney General’s Office hired a prominent law firm on behalf of Bowling Green State University to investigate the tragic hazing incident. The law firm’s report was issued on May 14, 2021, and the executive summary is available on the Bowling Green State University website.[xxxvii] Two passages of the executive summary are both telling and chilling. The sophomore pledge who died “was apprehensive about the event, and he told [non-fraternity] friends that he felt he had to drink an entire bottle of liquor or he could not join” the fraternity.[xxxviii] The executive summary further stated that “there is a culture and tradition of new members finishing or attempting to finish an entire fifth of alcohol “ at pledge initiations.[xxxix] As noted in the executive summary, the cause of death was fatal ethanol intoxication with a blood alcohol content of .35%.[xl] Ohio’s legal blood alcohol content is below .08%. This report summary and especially the factual summary and factual conclusion sections should be read by responsible parties at every higher education institution with fraternities and sororities, and appropriate remedial actions taken. I will end with a reprise of what I discussed at the beginning of the article. Given the requirements, complexities, and multitude of risk issues that colleges and universities face, a periodic and comprehensive compliance program evaluation is critical. The existing and emerging risks should place every institution on notice that their compliance program must be up to the challenge of the new normal in higher education. [i] Title IX of the U.S. Education Amendments of 1972 prohibits sex-based discrimination in college and university education programs or activities that receive federal funding.
[ii] The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act of 1990 (Clery Act) requires colleges and universities that receive federal funding to maintain and disclose campus crime statistics.
[iii] Freeh Sporkin & Sullivan, LLP, “Report of the Special Investigative Counsel Regarding the Actions of The Pennsylvania State University Related to the Child Sexual Abuse Committed by Gerald A. Sandusky,” July 12, 2012, 139, media.pennlive.com/midstate_impact/other/Report_Final_071212.pdf.
[iv] Jenna Johnson, “Federal officials probe Penn State’s possible Clery Act violations,” Washington Post, July 17, 2012, https://www.washingtonpost.com/local/education/federal-officials-probe-penn-state-for-possible-clery-act-violations/2012/07/17/gJQA8swirW_story.html.
[v] United States Sentencing Commission, Guidelines Manual, November 1, 2018, https://www.ussc.gov/sites/default/files/pdf/guidelines-manual/2018/GLMFull.pdf.
[vi] United States Department of Justice, Principles of Federal Prosecution of Business Organizations, July 2020, https://www.justice.gov/jm-9-28000-principles-federal-prosecution-business-organizations.
[vii] Ibid.
[viii] United States Department of Justice, Evaluation of Corporate Compliance Programs, updated June 2020, https://www.justice.gov/criminal-fraud/pages/file/937501/download.
[ix] Vivian Anguiano, “4 Actions Colleges Can Take To Address Police Brutality,” Center for American Progress, July 15, 2020, https://www.americanprogress.org/issues/education-postsecondary/news/2020/07/15/487647/4-actions-colleges-can-take-address-police-brutality/
[x] Kroll Associates, Inc., “Review and Investigation of Officer Raymond M. Tensing’s Use of Deadly Force on July 19, 2015: University of Cincinnati Police Department,” August 31, 2015, https://uc.edu/content/dam/uc/publicsafety/docs/Reform/documents/Kroll%20Report%20of%20Investigation%208.31.2015.pdf.
[xi] Kate Murphy and Mark Curnette, “University of Cincinnati pays $250k to ex-cop who killed Sam DuBose,” Cincinnati Enquirer, March 22, 2018, https://www.cincinnatiinquirer.com/story/news/2018/03/22/university-cincinnati-pays-cop-who-killed-sam-dubose/.
[xii] Kroll Associates, Inc. “Review and Investigation of Officer Raymond M. Tensing’s Use of Deadly Force on July 19, 2015: University of Cincinnati Police Department.”
[xiii] Ibid.
[xiv] Vivian Anguiano, “4 Actions Colleges Can Take To Address Police Brutality,” Center for American Progress, July 15, 2020, https://www.americanprogress.org/issues/education-postsecondary/news/2020/07/15/487647/4-actions-colleges-can-take-address-police-brutality/.
[xv] Jeremy Bauer-Wolf, “The Body-Cam Strategy,” Inside Higher Ed, May 12, 2017, insidehighered.com/news/2017/05/12/campus-police-force-start-adopt-body-cameras.
[xvi] Vivian Anguiano, “4 Actions Colleges Can Take To Address Police Brutality.”
[xvii] Ibid.
[xviii] Ibid.
[xix] Michelle Fletcher, Randolph Burnside and Stephanie Pink-Harper, “Determining the Level of Cultural Competence of College Police Departments: A Study of Three Different Campuses,’ Journal of Public Management & Social Policy, Volume 26, Number 1, June 2019, https://digitalscholarship.tsu.edu/cgi/viewcontent.cgi?article=1103&context=jpmsp.
[xx] United States Department of Education, “U.S. Department of Education Launches Investigation into Foreign Gifts Reporting at Ivy League Universities,” Press Release, February 12, 2020, https://content.govdelivery.com/accounts/USED/bulletins/27b7801.
[xxi] Ibid.
[xxii] The White House Office of Trade and Manufacturing Policy, “How China’s Economic Aggression Threatens the Technologies and Intellectual Property of the United States and the World,” June 2018.
[xxiii] United States Department of Justice, “Information About the Department of Justice’s China Initiative and a Compilation of China-related Prosecutions Since 2018,” March 9, 2021, https://www.justice.gov/nsd/information-about-department-justice-s-china-initiative-and-compliance-china-related.
[xxiv] United States Department of Education, “U.S. Department of Education Launches Investigation into Foreign Gifts Reporting at Ivy League Universities.”
[xxv] Erica L. Green, “Universities Face Federal Crackdown Over Foreign Financial Influence, New York Times, August 30, 2019, https://www.nytimes.com/2019/08/30/us/politics/universities-foreign-donations.html.
[xxvi]Elizabeth Redden, “Foreign Gift Investigations Expand and Intensify,” Inside Higher Ed, February 20, 2020, https://www.insidehighered.com/news/2020/02/20/education-department-escalates-inquiry-reporting-foreign-gifts-and-contracts.
[xxvii] Michael Stratford, “Universities fight scrutiny of foreign funding in Senate China bill,” Politico, May 27, 2021, https://www.politico.com/news/2021/05/27/universities-foreign-funding-china-491239.
[xxviii] Ibid.
[xxix] Renzo Downey, “Governor DeSantis unveils legislation to crackdown on Chinese influence,” FloridaPolitics.com, March 1, 2021, https://floridapolitics.com/archives/407993-ron-desantis-unveils-legislation-to-crackdown-on-chinese-influence/.
[xxx]University of California, Office of Ethics, Compliance and Audit Services Strategy – Foreign Influence Strategy, May 13, 2019, https://www.ucop.edu/ethics-compliance-audit-services/compliance/research/foreign-influence/html.
[xxxi] Ibid.
[xxxii] Jaclyn Jaeger, “Laureate Education launches FCPA probe into charitable donation,” December 20, 2016, Compliance Week, https://www.complianceweek.com/laureate-education-launches-fcpa-probe-into-charitable-donation/10086.article.
[xxxiii] United States Securities and Exchange Commission, SEC Form 8-K for Laureate Education, Inc., November 29, 2018, https://sec.report/Document/0001628280-18-014733/.
[xxxiv] Marlene Lenthang, “8 indicted in Bowling Green State University sophomore’s alleged hazing death,” ABC News, April 29, 2021, https://abcnews.go.com/us/indicted-bowling-green-state-university-sophomores-alleged-hazing/story?id=77398883.
[xxxv] Marlene Lenthang, “Bowling Green State University sophomore’s hazing death ruled an accident from ‘fatal ethanol intoxication,’” ABC News, April 7, 2021, https://abcnews.go.com/us/autopsy-bowling-green-university-sophomore-rules-death-accident/story?id=76926494.
[xxxvi] Johnny Diaz, “8 Indicted in Fraternity Hazing Death of Bowling Green Student,” New York Times, April 29, 2021, https://www.nytimes.com/2021/04/29/us/stone-fotlz-death-bowling-green.html.
[xxxvii] Barnes & Thornburg, “Executive Summary of Barnes & Thornburg Investigation into Pi Kappa Alpha Fraternity (PKA) Event on March 4, 2021,” May 14, 2021, https://www.bgsu.edu/content/dam/BGSU/news/2021/05/Executive-Summary-BT-PKA-Investigation.pdf.
[xxxviii] Ibid.
[xxxix] Ibid.
[xl] Ibid. About Martin Biegelman Martin Biegelman, CFE, CCEP Managing Director & Investigations Practice Leader SunHawk Consulting, LLC Martin.Biegelman@SunHawkConsulting.com Martin Biegelman has spent a lifetime detecting, investigating, and preventing fraud and corruption in various leadership roles in law enforcement, consulting, and the corporate sector. His work on behalf of corporate management and boards includes conducting internal investigations, including independent investigations, alleging fraud, corruption, Foreign Corrupt Practices Act violations, conflicts of interest, whistleblower retaliation, and other employee and vendor misconduct. Martin’s work also includes developing, assessing, and enhancing corporate compliance and ethics programs including internal investigative and anti-bribery compliance programs, as well as performing fraud risk assessments. Click Here to view Martin's full bio SunHawk Consulting and its compliance consultants and advisors are highly experienced in conducting independent investigations with outside counsel. Their investigative experience includes financial accounting fraud, conflicts of interest, inappropriate personal relationships, harassment, whistleblower retaliation, and other organizational code of conduct violations. Our subject matter experts can provide insight into your specific risk and other compliance program needs. We are happy to have a discussion with you and determine how we can possibly assist you in responding to and mitigating risk.

SunHawk's OIG Work Plan June 2021 Update

SunHawk's OIG Work Plan June 2021 Update

HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The OIG Work Plan sets forth various projects, including OIG audits and evaluations, that are underway or planned to be addressed during the fiscal year and beyond. SunHawk's OIG Work Plan Summary Report summarizes currently active Work Plan items and sorts relevant Work Plans items into Provider and Payer categories. CLICK HERE to download the OIG Work Plan Summary Report for PROVIDERS CLICK HERE to download the OIG Work Plan Summary Report for PAYERS SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn.

If additional information would make this report more valuable to you, please reach out and give us your thoughts.

Jan.Elezian@SunHawkConsulting.com Kimulet.Winzer@SunHawkConsulting.com
Jim@SunHawkConsulting.com

SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

National Institutes of Health (NIH) Work Plan and Audit Summary June 2021 Update

National Institutes of Health (NIH) Work Plan and Audit Summary June 2021 Update

SunHawk’s review of OIG Audit statistics in 2020 found that compliance professionals and business risk owners experienced a 58% increase in HHS OIG audit activity over the prior year. In an effort to promote the value of shared learnings, as well as give our colleagues and clients organized summaries of HHS OIG Work Plan and Audit items, SunHawk Consulting, LLC, has gathered, organized, and summarized the HHS OIG Work Plan and Audit Summaries of HHS National Institutes of Health (NIH). HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The Work Plan and Audit item summaries provided herein are referenced by their respective Work Plan/Audit numbers at the end of each abstract. The electronic version of this report includes hyperlinks to the original Work Plan and Audit item summaries. CLICK HERE to download the National Institutes of Health (NIH) Work Plan and Audit Summary Report SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn.

If additional information would make this report more valuable to you, please reach out and give us your thoughts.

Jan.Elezian@SunHawkConsulting.com Kimulet.Winzer@SunHawkConsulting.com
Jim@SunHawkConsulting.com

SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

SunHawk's HHS OIG Audit Summary Reports - Provider and Payer June 2021 Update

SunHawk's HHS OIG Audit Summary Reports - Provider and Payer June 2021 Update

HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The findings and recommendations provided herein are extracted from the specific audits included in this report and referenced by their respective report numbers at the end of each abstract. SunHawk’s reports summarize completed audits and evaluations over the last 12 months and sorts relevant audits into the Provider and Payer categories. For the PROVIDER-FOCUSED Completed Audit Summary Report CICK HERE For the PAYER-FOCUSED Completed Audit Summary Report CLICK HERE SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn. If additional information would make this report more valuable to you, please reach out and give us your thoughts. Kimulet.Winzer@SunHawkConsulting.com James.Rose@SunHawkConsulting.com Jan.Elezian@SunHawkConsulting.com Jim@SunHawkConsulting.com SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

HCCA/SCCE Virtual Event "Day One as a New Compliance Officer" featuring Jan Elezian and James Rose

HCCA/SCCE Virtual Event "Day One as a New Compliance Officer" featuring Jan Elezian and James Rose

SunHawk Consulting, LLC is excited to announce that Managing Director, James Rose, and Director, Jan Elezian will be speaking at the HCCA/SCCE Webinar Day One as a New Compliance Officer. James and Jan will be joined by Gerry Roy, VP, Chief Compliance & Privacy Officer, Phoenix Children’s Hospital. This presentation will provide a framework for new compliance officers to understand their areas of risk, describe effective tools for reviewing the current state of a compliance program, and provide a blueprint for successfully building an effective compliance program. Additionally, attendees will learn how to identify the order in which they should tackle existing compliance concerning. To register for this event, click HERE! SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs and budgets come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management and employees, special committees, bankruptcy trustees and receivers, and government agencies.

SunHawk Consulting, LLC launches Investigations Practice led by Managing Director Martin Biegelman

SunHawk Consulting, LLC launches Investigations Practice led by Managing Director Martin Biegelman

SunHawk Consulting is excited to announce the launch of our Investigations Practice, established to assist law firms and corporate clients in successfully mitigating risk and promoting compliance. The SunHawk Investigations Practice is led by Martin Biegelman, CFE, CCEP, who has spent his 45-year career detecting, investigating, and preventing fraud and corruption in leadership roles in law enforcement, consulting, and the corporate sector. Martin is joined by James Rough, CFE, CHC, CCEP, Juliette Gust, CFE, Douglas Small, CEP, CFE, CFF, Jerrold Bamel, Glenn Ferry and Michael Kotch, CFE, CMAS, CFCE who have long careers and significant experience conducting forensic investigations of fraud, FCPA, and other corporate misconduct. The SunHawk Investigations Practice team have been retained by law firms, corporate management, and boards for internal investigations, as well as independent investigations. SunHawk professionals have collectively conducted and managed thousands of investigations in over 75 countries. Our roster includes former federal agents, professional services consultants from the major accounting firms, as well as directors of investigations for leading companies. Our subject matter experts and thought leaders can step in to support or lead an investigation from the discovery of the issue to resolution and remediation. SunHawk professionals have worked with clients on a variety of matters involving investigations and forensic analysis, and have experience in the following areas: Foreign Corrupt Practices Act Kickbacks and other employee and vendor collusion Fraudulent financial accounting Asset misappropriation schemes including embezzlement, expense reporting, billing, procurement, and other schemes Improper use of company assets and theft Whistleblower retaliation False Claims Act and qui tam actions Conflicts of interest Code of conduct, ethics, and other business-related investigations Anti-money laundering State and federal investigations, including violations of healthcare laws and regulations The SunHawk Approach to Consulting Services Who We Are • SunHawk Consulting is a team of highly skilled and experienced subject matter experts in conducting internal investigations for various industry clients. We understand the client’s need for resolution and remediation strategies to protect the organization from financial, litigation, and reputational risk. SunHawk’s Value Proposition • At SunHawk, our clients’ needs, and budgets, come first. • We are experts without the overhead of the Big 4 and other larger firms. • ​We recognize that most companies have internal litigation, compliance, audit, and investigation capabilities and have a strong desire to minimize unnecessary costs. ​SunHawk professionals are committed to: • Institute cost-effective pricing for every engagement; and • Leverage the client’s internal workforce when possible Meet the SunHawk Investigations Practice Team Martin Biegelman, CFE, CCEP Managing Director & Leader of the SunHawk Investigations Practice Martin has spent his 45-year career detecting, investigating, and preventing fraud, theft, and corruption as well as the development and implementation of compliance programs while in leadership roles in law enforcement, consulting, and the corporate sector. Martin’s work on behalf of outside counsel, corporate management and boards involves internal investigations alleging fraud, theft, corruption, FCPA violations, kickbacks, conflicts of interest, whistleblower retaliation, and other employee and vendor misconduct. He previously served as a Managing Director in Deloitte’s Risk and Financial Advisory Practice where he partnered with clients to help them navigate disruption, resolve business controversy, and build resilient organizations. In 2002, he founded Microsoft Corporation’s Financial Integrity Program and led that global business conduct investigations program until 2011. He is both a Certified Fraud Examiner and a Certified Compliance & Ethics Professional. Martin is also a licensed Private Investigator in Arizona. Juliette Gust, CFE Director Juliette has personally conducted or led close to 2,000 investigations spanning 75 countries and has advised on more than 10,000 employee ethics line reports of fraud, theft, or other misconduct. She has over 20 years of experience in building global ethics and compliance programs in the financial services, manufacturing, hospitality, and retail industries. Juliette developed and was the Director of the Fraud & Investigations team for a global Fortune 500 company with 180,000 employees in more than 100 countries. She also served as the Project Manager and a core member of the company’s Anti-Corruption compliance program, leading the development of a best-in-class global anti-corruption risk assessment, audit plan, and third-party due diligence program. Juliette specializes in designing, implementing, and monitoring internal whistleblower reporting programs and tools. She is a Certified Fraud Examiner and is fluent in Spanish. Douglas Small, CPA, CFE Director Douglas has over 30 years of experience advising clients in all aspects of internal corporate fraud investigations, forensic accounting matters, adherence to U.S. laws including the Foreign Corrupt Practices Act and white-collar criminal matters. He provides expert services on financial fraud and fraud risk management, anti-corruption and forensic accounting investigations throughout the world. Additionally, he spent 14 years as a Special Agent with the Federal Bureau of Investigation where he conducted numerous complex white-collar criminal investigations to include, mortgage fraud, corporate fraud, health care fraud, money laundering, wire fraud, mail fraud and public corruption. He has worked extensively providing analysis of financial and accounting records, interviewing subjects and witnesses, and providing clients with actionable information to address these pressing issues. Douglas is both a Certified Public Accountant and a Certified Fraud Examiner. James Rough, CFE, CHC, CCEP President Jim has over 20 years of experience in leading or having significant roles in high-profile forensic investigations and compliance reviews domestically as well as in Europe and the Middle East. He regularly advises clients on matters involving the False Claims Act, Affordable Care Act, Stark Law, Anti-Kickback Statute, Healthcare Fraud and other fraud and corruption issues. Jim has provided significant support to clients communicating complex issues to regulatory and enforcement personnel, including the Department of Justice and the Health and Human Services Office of Inspector General. He has communicated investigation and/or audit findings directly to CMS, State Medicaid Auditors, and to the Securities and Exchange Commission’s enforcement personnel. He has also served as a non-testifying subject matter expert to white-collar defense counsel in high-profile criminal DOJ, civil SEC, and class action proceedings. Jim is a Certified Fraud Examiner, Certified in Healthcare Compliance, and is a Certified Compliance & Ethics Professional. Jerrold Bamel Director Jerrold Bamel brings over 35 years of federal and corporate investigative experience to the SunHawk Investigations Practice. Jerry is a retired Supervisory Special Agent with the Federal Bureau of Investigation. His FBI experience ranges from conducting fraud and bribery investigations to conducting complex international terrorism investigations overseas. Jerry was selected by the FBI to be the Assistant Legal Attaché at the United States Embassy, Singapore to the Office of the Legal Attaché where he was responsible for all FBI investigative and liaison matters in Singapore, Malaysia, and Indonesia. Upon retirement from the FBI, Jerry was hired by Microsoft in Singapore as their first overseas fraud, ethics, and compliance investigator. He spent over 15 years at Microsoft and developed and managed the Financial Integrity Unit’s business conduct investigations program, first in the Asia Pacific Region and then in the Latin America. He has extensive international investigations experience ranging from conflict of interest to procurement and marketing fraud to bribery as well as conducting compliance training to Microsoft employees. Jerry has received numerous awards and recognition from the FBI, the Department of Justice, and other foreign and domestic organizations for the investigations he conducted. He is most proud to be a recipient of the FBI Shield of Bravery and the FBI Agents Association’s J. Edgar Hoover Memorial Award for Valor. Glenn Ferry Director Glenn has over 30 years of combined experience in senior Federal law enforcement management, leadership experience in successfully identifying, investigating, and preventing complex Medicare and Medicaid health care fraud schemes. He served as the Special Agent in Charge of the Los Angeles Region at the U.S. Department of Health & Human Services Office of Inspector General. ​ Following his distinguished career at HHS OIG, Glenn served as the Program Director with a Medicare Program Integrity Contractor. He coordinated and supervised investigations of all health care provider types. Most recently, Glenn served as V.P. of Operations & Law Enforcement Liaison with the Medicare Unified Program Integrity Contractor, Western Jurisdiction that covers 13 states. His responsibilities included providing leadership, training to staff conducting investigations, initiating appropriate and effective administrative actions, and and preparing high quality fraud referrals to law enforcement. Michael Kotch, CFE, CMAS, CFCE Director Michael Kotch has over 35 years of experience in government health programs, strategic planning, compliance, and provider network management. In addition, he is a seasoned healthcare fraud and financial crimes investigator who has developed and implemented anti-fraud programs and managed Special Investigation Units for several large managed care organizations. Michael has served as a commissioned US Army Medical Service Corps Officer, where he was assigned to mid- and senior-level advisory and management roles at hospitals and clinics, as well as the Headquarters of the United States Army Health Services Command. Subsequently, he was selected to direct and manage financial operations at Keller Army Community Hospital supporting the United States Military Academy, West Point, where he was also designated the Assistant Inspector General for Medical Affairs. After completing military service, Michael successfully leveraged his education, knowledge, skills, and abilities in the private sector. He has held numerous senior-level management positions and has made numerous contributions to achieving organizational goals at health care organizations across the United States. Michael has worked in various consulting roles as a Subject Matter Expert and Project Manager, including financial and operational auditing, regulatory compliance, appeals and grievances, and the prevention, detection, investigation and reporting of suspected fraud, waste, and abuse. Contact Us SunHawk Consulting and its compliance consultants and advisors are highly experienced in conducting internal investigations, including independent investigations, for clients. Our subject matter experts can provide detailed insight into your specific risk issues and other compliance program needs. We are happy to discuss your investigation needs. JIM ROUGH
President
SunHawk Consulting, LLC
602-334-5522
Jim@SunHawkConsulting.com MARTIN BIEGELMAN
Managing Director
SunHawk Consulting, LLC
425-213-7344
Martin.Biegelman@SunHawkConsulting.com

Retaliation: The Insider Threat That Can Shatter an Organization and Its Culture

Retaliation: The Insider Threat That Can Shatter an Organization and Its Culture

Every single corporate code of conduct I have read over the years discusses the protection of employees who report possible violations. Furthermore, those codes reiterate how the organizations will not tolerate any form of retribution against anyone for reporting in good faith. The codes opine on how seriously the organizations consider retaliation and the various disciplinary actions that can be taken against anyone who impedes organizational justice. Employees are trained to report allegations to their managers or to use the multitude of other reporting channels detailed in the codes. Executives, managers, compliance officers, human resource professionals, and others continuously reinforce employee protections and non-retaliation policies. Yet retaliation remains a constant insider threat in both business and government environments. What makes retaliation such a problem is the human curiosity that makes people want to know who made the allegation against them or their company. All too often it is the senior leadership of an organization who wants to identify those who report misconduct and then retaliate against them. It is almost a personal affront to some in management when an employee dares to question their actions, even if those actions are improper. In recent years we have seen a spike in whistleblower complaints alleging retaliation from those in positions of power. Chief Retaliation Officers The chief executive officer of an organization is supposed to live the company values and promote tone at the top. Unfortunately, we have seen examples of where the CEO is more like the chief retaliation officer in targeting whistleblowers. In 2018, UK financial regulators fined investment bank Barclay’s CEO $1.5 million for using company resources to determine the identity of an anonymous whistleblower who questioned the qualifications of an executive that the CEO of the bank hired.[i] Evidently, this CEO took the allegation personally and conveniently forgot about tone at the top and company policy and ordered Barclay’s head of security to learn the name of the whistleblower. As the financial regulator overseeing the matter stated, the CEO “acted unreasonably in proceeding in this way and, in doing so, risked undermining confidence in Barclay’s whistleblowing policy and the protections it afforded to whistleblowers.”[ii] Here is a more egregious example of a corporate executive trying to unmask a whistleblower. In 2019, Reuters reported that the then-CEO of the Brazilian metals and mining company Vale SA was more interested in finding out who sent an anonymous email alleging concerns about the structural safety of area dams than in determining the validity of the email.[iii] The eventual collapse of one of the dams resulted in the death of more than 250 people. The CEO and other company executives were subsequently indicted for homicide by Brazilian authorities. A government report on the tragedy commented that the former CEO “had full knowledge of the necessity of adopting urgent measures to increase the security of the dams in the priority area.”[iv] Yet, identifying the anonymous sender of the email became the CEO’s priority. Retaliation Is All Too Common I also encountered the damaging effect of retaliation in my work for corporate clients. I was evaluating an organization’s compliance program and learned that employees did not trust the company’s hotline reporting system. I conducted focus groups of employees and was told of their horror stories when reporting misconduct. In one example, an employee called the company’s hotline and identified herself thinking her identity would be kept confidential. It was not, and other employees learned that she was the one who reported the misconduct. In another example, an employee reported allegations of misconduct to his manager, again in confidence. Employees in his group learned that he was the source of the information and it was his manager who disclosed it. Both employees then told me that they were subsequently retaliated against for doing what their code of conduct required they do, and they would never again report any concerns. What makes retaliation such a problem is the innate way that people want to know the identity of the person who made an allegation against them or their company. It bears repeating that it can be senior management who want to identify whistleblowers and retaliate against them. As such the retaliation can take many forms. Retaliation is more than just being fired or demoted. It can occur by being denied overtime or promotions or being reassigned to less desirable positions. It can be insidious by being subjected to threats, blacklisting, and false accusations. It can also be subtle such as being ostracized or left off meeting invitations and email communications. Retaliation continues as one of the biggest concerns of employees. Study after study confirms this. According to the Equal Employment Opportunity Commission, “Retaliation is the most frequently alleged basis of discrimination in the federal sector and the most common discrimination finding in federal sector cases.”[v] The fear of retaliation hinders many employees from coming forward to report allegations. So, what more can organizations do to ensure the safety of their employees to report misconduct without the fear of retribution? For whistleblower and hotline reporting programs to be successful, there needs to be appropriate non-retaliation policies and procedures. Even more important, there needs to be a strong organizational commitment in words and actions. Policies matter but only if employees believe that they will be more than just words on paper. Employees must feel empowered and safe so they can anonymously and confidentially report violations of an organization’s standards of business conduct and know they will be protected from retaliation. The Right Culture Bests Retaliation Here are some of the leading practices that organizations can implement to lessen the risk of retaliation and promote a culture of ethics and compliance: First and foremost, establish a persuasive tone at the top and throughout the organization that leaves no doubt that retaliation in any form is unacceptable and that swift and compelling action will be taken against anyone engaging in such a practice. Anyone must truly mean anyone in the organization, no matter their level. This stance needs to be continuously evangelized to employees. Ensure that the organization’s code of conduct includes a strong non-retaliation policy that details the many forms of retaliation and an immediate reporting requirement. Have an anonymous and confidential third-party managed hotline/helpline for employees and others such as contractors, vendors, and customers, to report concerns. Communicate that the reporting channel is externally managed. Explain the difference between anonymity and confidentiality. Confidentiality implies the caller’s identity and information will not be communicated broadly and only to those with an absolute need to know. Anonymity provides secrecy and nondisclosure for the caller’s identity but not the information provided. Take all tips and complaints seriously by thoroughly vetting them upon receipt using a risk-based analysis process, and then investigate professionally and timely. Broadly and frequently communicate the organization’s internal reporting process, investigation protocols, and non-retaliation policies. Appropriately discipline those who retaliate and consider publicizing to employees that such discipline has occurred. Consult with legal counsel before such a public disclosure. Consider keeping those who report misconduct informed of actions being taken to the extent possible. I know of one company that has a specific group whose function is to keep employees who report misconduct aware of the investigation status and the results of the investigation. Unfortunately, even leading practices will not stop retaliation. In April 2021, compliance management firm NAVEX Global reported the findings from their 2021 Incident Management Benchmarking Report. The report found that the number of retaliation reports by employees has declined in recent years. This is after years of increased reporting of retaliation. The reason for the decline in employee reporting is not because of an actual decrease in retaliation but a heightened fear of retaliation. If left unchecked, the insider threat of retaliation can do irreparable harm to an organization and its culture. Don’t let it happen to your organization. [i] “Whistleblower ‘mistake’ cost Barclays CEO $1.5 million,” CNN, May 11, 2018, https://money.cnn.com/2018/05/11/investing/barclays-ceo-jes-staley-fine-pay/index.html
[ii] “Barclays CEO fined $1.5mn for trying to unmask whistleblower,” Gulf Times, May 12, 2018, https://www.gulf-times.com/story/592424/
[iii] “Vale CEO received anonymous email warning ahead of Brazil dam disaster: congress report,” Reuters, November 4, 2019, https://news.yahoo.com/vale-ceo-received-anonymous-email-032251228.html
[iv] Ibid.
[v] U.S. Equal Employment Opportunity Commission, www.eeoc.gov/retaliation About Martin Biegelman Martin Biegelman, CFE, CCEP Managing Director SunHawk Consulting, LLC Martin.Biegelman@SunHawkConsulting.com Martin Biegelman has spent a lifetime detecting, investigating, and preventing fraud and corruption in various leadership roles in law enforcement, consulting, and the corporate sector. His work on behalf of corporate management and boards includes conducting internal investigations, including independent investigations, alleging fraud, corruption, Foreign Corrupt Practices Act violations, conflicts of interest, whistleblower retaliation, and other employee and vendor misconduct. Martin’s work also includes developing, assessing, and enhancing corporate compliance and ethics programs including internal investigative and anti-bribery compliance programs, as well as performing fraud risk assessments. Click Here to view Martin's full bio SunHawk Consulting and its compliance consultants and advisors are highly experienced in conducting independent investigations with outside counsel. Their experience includes financial accounting fraud, conflicts of interest, inappropriate personal relationships, harassment, whistleblower retaliation, and other organizational code of conduct violations. Our subject matter experts can provide insight into your specific risk and other compliance program needs. We are happy to have a discussion with you and determine how we can possibly assist you in responding to and mitigating risk.

NEW! National Institutes of Health (NIH) Work Plan and Audit Summary Report

NEW! National Institutes of Health (NIH) Work Plan and Audit Summary Report

SunHawk’s review of OIG Audit statistics in 2020 found that compliance professionals and business risk owners experienced a 58% increase in HHS OIG audit activity over the prior year.1 In an effort to promote the value of shared learnings, as well as give our colleagues and clients organized summaries of HHS OIG Work Plan and Audit items, SunHawk Consulting, LLC, has gathered, organized, and summarized the HHS OIG Work Plan and Audit Summaries of HHS National Institutes of Health (NIH). HHS OIG Office of Audit Services and Office of Evaluation and Inspections issues approximately 300 audits and evaluations a year. The Work Plan and Audit item summaries provided herein are referenced by their respective Work Plan/Audit numbers at the end of each abstract. The electronic version of this report includes hyperlinks to the original Work Plan and Audit item summaries. CLICK HERE to download the National Institutes of Health (NIH) Work Plan and Audit Summary Report SunHawk’s team of experts are always available to offer their assistance. To stay apprised of the future reports subscribe to our newsletter and follow us on LinkedIn.

If additional information would make this report more valuable to you, please reach out and give us your thoughts.

Jan.Elezian@SunHawkConsulting.com Kimulet.Winzer@SunHawkConsulting.com
Jim@SunHawkConsulting.com

SunHawk Consulting is a team of highly skilled and experienced subject matter experts in the Healthcare, Life Sciences, and Insurance Industries who understand that the client’s needs come first. SunHawk provides Crisis Management Response, Compliance Consulting, Disputes & Investigations, and Staff Augmentation services for Boards of Directors, internal/external legal counsel, company management, special committees, and government agencies.

SUNHAWK RESOURCES