Corporate Compliance

Our compliance experts bring extensive experience from leadership roles within both corporate compliance departments and government enforcement and regulatory agencies.  Forensus’ experts regularly provide advice to clients involving corporate compliance programs, internal audit functions, risk assessment, and responses to government auditors.compliance expert

We target specific issues and allegations using a surgical approach to achieve actionable and efficient results.  Experience matters and our recognized experts have developed rigorous analysis in support of corporate compliance and ethics teams for over a decade.

Our experts have been retained by the Department of Justice to provide expert testimony on matters of corporate compliance and our team includes professionals who are Certified Public Accountants (CPAs), Certified Anti-Money Laundering Specialists (CAMS), and Certified in Healthcare Compliance (CHC).

Representative Casework

Testifying Compliance Expert – False Claims Act

Retained as a testifying healthcare compliance expert on behalf of the Department of Justice’s Civil Division in support of False Claims Act litigation. Evaluated the defendant’s compliance program and authored an expert report rendering opinions related to the company’s risk assessment and compliance activities. The defendant settled with DOJ agreeing to pay over $15 million.

Medical Device Manufacturer Compliance Investigation

Managed the forensic accounting investigation of a Fortune 100 medical device manufacturer regarding improper payments and gratuities provided to physicians, hospitals, and teaching institutions in contradiction with the PhRMA code. Identified specific improper payments disguised as charitable sponsorships, honoraria, and R&D equipment.

Statistical Sampling & Extrapolation

Retained as a consulting sampling expert on behalf of a Fortune 500 hospice provider to design and select a statistically valid random sample (SVRS) of patient claims. Implemented stratification and cluster sampling and worked closely with clinical experts to extrapolate decisions of medical necessity.

Post-Acquisition Investigation – Expert Report

Retained as a testifying expert on behalf a $100 million pharmacy services company to conduct an internal investigation related to the company’s acquisition. Analyzed financial records related to payer obligations for federal, state, and 3rd party payments.   Quantified in excess of $50 million of financial damages due to improper billing and accounting practices.

CMS Repayment Appeals – Expert Report

Retained on multiple occasions as a testifying sampling expert on behalf of a physician practices to assess the statistical validity and conclusions of Centers for Medicare and Medicaid Services (CMS) demands for repayment. Authored expert reports in support of the practice’s repayment appeal.

Internal Investigation – Revenue Recognition

Conducted an investigation in response to a formal SEC inquiry on behalf of a Fortune 100 energy parts manufacturer. Addressed the treatment of in-transit products and the timing of revenue recognition. The investigation resulted in a $128MM restatement of earnings.