Government Enforcement

Clients rely on Forensus to help detect and respond to issues of suspected fraud.  Our experts regularly support individuals and companies faced with allegations of white-collar violations including SEC, DOJ, FTC and other regulatory enforcement.white collar forensic accountant

We target specific issues and allegations using a surgical approach to achieve actionable and efficient deliverables.  Experience matters and our team of recognized experts and former agents have developed rigorous analysis in support of white-collar defense teams for over a decade.

Corporate officers and directors are routinely confronted with the potential for government sanctions, enforcement, and personal liability. Consequently, necessary precautions are required to reduce their exposure. Our expertise addressing white-collar enforcement helps clients to identify and mitigate risks to advance corporate integrity.

Representative Casework

Internal Investigation – Anti-Kickback Statute

Our professionals led the forensic accounting investigation of a complex network of physicians to identify the structure and timing of allegedly improper referrals and kickbacks. Analyzed the business and personal financial records of subjects to create a comprehensive timeline illustrating the financial organization illicit network. While this investigation originally involved two physicians, our investigators identified a complex network of over 35 physician groups, and three additional kickback networks.

Medical Device Manufacturer 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.

Criminal Fraud – Expert Testimony

Testified as an expert in U.S. District Court rendering opinions on forensic accounting and statistical analysis related to allegations of criminal healthcare fraud. Statistically sampled and analyzed medical equipment billing and coding records along with patient medical records to identify indicia of fraud and to calculate financial damages.  We analyzed over 100,000 lines of hospital billing data to determine the amount of reimbursement from Medicare/ Medicaid related to the doctors and practice groups in question.

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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.

Healthcare Fraud Investigation

Led multiple fraud investigations of provider practices to assess, identify, and quantify issues of improper billing code manipulation. Issues included cases of billing for unnecessary procedures, billing for procedures never performed, “unbundling” of billing codes, and inflation of bills by “up coding”. Worked closely with Department of Health and Human Services (HHS) and counsel to analyze and synthesize billing data for a variety of clinical providers.

False Claims Act – Government Forensic Accounting

Our professionals led the forensic accounting investigation of whistleblower allegations at a Fortune 100 device manufacturer. Allegations included inflation of costs on over $650M of cost-plus contracts for the U.S. Government, and improper application of government Cost Accounting Standards (CAS) in accordance with the Federal Acquisition Regulation (FAR). Reviewed over five years of cost disclosure documentation and worked closely with the DCAA to assess the materiality of issues identified. Identified multiple process weaknesses and worked closely with the client to remediate deficiencies resulting in no financial sanctions against the company.

white collar forensic accountant