January 24, 2022


News Network

Acting Deputy Assistant Attorney General Robert A. Zink Delivers Remarks at Virtual GIR Live Interactive: Regional Spotlight-North America

18 min read
<div>It’s wonderful to speak with you here this morning. And I’m sorry we can’t do this in person. But I’m still delighted to have the opportunity to be here to say a few words about white-collar criminal enforcement, albeit virtually.</div>

Remarks as Prepared for Delivery

Good morning. 

Thank you—Joe and Bruce—for the very kind invitation to be here today.

It’s wonderful to speak with you here this morning.  And I’m sorry we can’t do this in person. 

But I’m still delighted to have the opportunity to be here to say a few words about white-collar criminal enforcement, albeit virtually. 

I’m appearing here today in my capacity as Acting Deputy Assistant Attorney General in the Department’s Criminal Division. 

My responsibilities include helping to oversee the Criminal Division’s Fraud Section. 

For over a decade, I’ve had the honor and privilege of working alongside my close friends and colleagues in the Fraud Section. 

It’s a place I love, it has an incredibly important mission, and I’m proud to report that the Section continues to produce results in ways the American people should be tremendously proud of.     

We’ve had an incredibly busy year, notwithstanding the obvious difficulties associated with the pandemic. 

We’ve continued to bring impactful white-collar cases all across the country, both against offending individuals and corporate entities.   

I thought I’d start off today by reflecting on our body work this year.  I do so for three reasons.     

First, because it’s important that the Division is held accountable by the public for its work—both good and bad.

Second, because we’ve had an extraordinarily productive year.

And I’ll never pass up the opportunity to highlight the work of the tremendously talented and hard-working women and men of the Fraud Section.

And finally, because in looking back over our work this year, two themes emerge that I want to emphasize—cooperation and coordination. 

And it’s these two themes that I’d like to offer a few words on today.   

So, first, our year in review. 

While the year is not yet over and more is certainly left to be done, the work of the Fraud Section to date has been remarkable.

This year, again, has seen the Fraud Section help set the pace for federal white-collar criminal enforcement in the United States, judged by any measure—whether by number of cases charged, size of cases charged, significance of cases resolved, or any number of other metrics. 

In a year where many have lamented a perceived downturn in white-collar enforcement, we at the Fraud Section have seen no such downturn; in fact, just the opposite. 

Production continues to be high and our results speak to that, notwithstanding the limitations we all have faced by virtue of the pandemic.

So, let’s turn to the numbers.  

From January 1 of this year to this past Monday, the Fraud Section has publicly:

  • Charged 303 individuals with various federal crimes;
  • Convicted 198 individuals of various federal crimes; and
  • Reached criminal resolution with 13 different corporations for various violations of federal criminal law.

With respect to these 13 corporate criminal resolutions, they include:

  • Over $8.9 billion in global monetary amounts—an all-time high-water mark for the Fraud Section;
  • Over $4.4 billion in U.S. monetary amounts;
  • Nearly $3 billion in U.S. criminal amounts; and
  • Criminal charges against well over 20 individuals for their roles in the underlying schemes upon which corporate criminal liability is based.

These corporate cases have been brought across a range of industries, from aircraft manufacturing, to financial services, to the pharmaceutical industry.

They have involved conduct in countries around the world, from Brazil, to Venezuela, to the United Kingdom, to France, to Singapore and Malaysia, and of course right here in the United States. 

The Fraud Section’s individual and corporate cases, taken together, address conduct that has profoundly devastating consequences at home in the United States and, indeed, around the globe.

Conduct ranging from international corruption to prescription opioid abuse; from widespread market manipulation to health care fraud; from investment swindles to government procurement fraud; and everything else in between.

Our prosecutions this year have brought accountability to the highest ranks of company management. 

They’ve involved some of the biggest and most well-known corporate entities in the world.

Which matters, because this type of accountability reminds companies and individuals that no person, and no company, is above the rule of law.

The Fraud Section has been busy at work protecting the public, and our actions this year speak more loudly than any words I can offer to you here today. 

This year also saw the Fraud Section utilize data in innovative and creative ways to identify, detect and, where appropriate, charge federal crimes. 

We have embraced, wholesale, the proposition that data can and does serve as a significant indicator of fraud, foreign bribery, and other white-collar offenses. 

We have invested in data analysis and used data to initiate many of our criminal investigations—often covertly—to obtain evidence while the underlying offense is still being committed and without the criminal offenders’ knowledge of our investigation. 

Our efforts using data to identify criminal conduct have yielded considerable cases and results.

Expect the Fraud Section to do more on this front in the coming months and years. 

Under the creative and dynamic leadership of Fraud Section management, I have every expectation that the Section will find new and smarter ways to identify, detect, investigate, and prosecute significant white-collar criminal offenses based on leads generated through data analysis.   

This year also saw the Fraud Section stand up a first-of-its kind Unit—the Special Matters Unit. 

This Unit was established to focus on issues related to privilege and legal ethics. 

It conducts privilege reviews on behalf of the Section to ensure that prosecutors on the case team are not exposed to potentially privileged material.

The Unit litigates privilege-related issues in connection with the Fraud Section’s cases in federal court. 

These efforts, among many other things, include handling evidentiary hearings related to privilege issues and litigating matters related to the crime-fraud exception to the attorney-client privilege. 

The Unit also provides training and guidance to Fraud Section prosecutors on matters relating to privilege and evidence handling.

The Special Matters Unit was formally established this year to, on the one hand, help safeguard the rights of those under investigation; and on the other, to help ensure the Section’s investigations and prosecutions are not jeopardized by reviewing errors. 

Going forward, expect this Unit to be a leader in the Department’s efforts to properly handle matters relating to the attorney-client privilege.     

This year also saw a spate of individual criminal charges brought by Fraud Section prosecutors against health care defendants. 

On September 30 of this year, and in connection with our annual healthcare fraud takedown, the Fraud Section secured charges against 140 defendants in cases involving over $2.9 billion in charged losses. 

The conduct alleged included false billings, forged documents, the payment of bribes and kickbacks, and the unlawful distribution of prescription opioids, among others.

We estimate that our efforts to combat healthcare fraud across the United States have saved billions for the federal fisc. 

And we also are confident that our criminal enforcement efforts directly contribute to the provision of better healthcare to Americans across the country. 

Expect our efforts in this respect to continue, at pace, for the foreseeable future. 

Finally, this year saw the Fraud Section stand up, in what must be record time, a criminal enforcement program to investigate and prosecute fraud in connection with the Paycheck Protection Program, or PPP—that is, the program established by Congress under the CARES Act to provide relief monies to small businesses and their employees during a period of national emergency.

We did this because, when the CARES Act was passed we, at the Fraud Section, hoped for the best, but knew we had to prepare for, and protect against, the worst.

We hoped individuals and related businesses would submit honest applications for money that they deserved. 

But we had to prepare for, and protect against, those who would take advantage of this program by submitting false declarations and dummy documents to justify their receipt of PPP monies. 

Our preparation was not in vain.

Within weeks of the first wave of PPP monies being distributed, we charged our first case. 

Since that time and to date, the Section has secured charges against over 90 individuals in cases involving alleged losses totaling over $250 million.

We are proud of our efforts to safeguard this important government program and will continue to investigate and prosecute these cases moving forward.    

With that background, I’d also like to talk about two key points that are reflected in the Section’s work, particularly with respect to our corporate criminal enforcement efforts.

They are the value of cooperation and the importance of coordination.

First, let me touch on the value of cooperation. 

Department policy is clear. 

Under the Principles of Federal Prosecution of Business Organizations, a company may receive cooperation credit if the company “identif[ies] all individuals substantially involved in or responsible for the misconduct at issue, regardless of their position, status or seniority, and provide[s] to the Department all relevant facts relating to that misconduct.”

And under the Department’s FCPA Corporate Enforcement Policy—which the Division applies to all corporate matters within the Fraud Section—a company is entitled to a significant percentage reduction off the low-end of the otherwise appropriate advisory Sentencing Guidelines range, so long as the company satisfies certain criteria set forth in the policy.

Taken together, these policies (1) establish what cooperation is, (2) provide a baseline and threshold to obtain cooperation credit, (3) provide specific guidance regarding how to go about obtaining cooperation credit, and (4) go so far as to articulate specific reductions based on the quality of a company’s cooperation.   

We, at the Fraud Section, have been consistent in our application of these principles and policies in our work. 

And we are public and transparent in how we apply these principles and policies to our resolutions. 

You have seen this in our cases this year.

In the Section’s corporate resolution papers this year, you saw companies of widely different types, in widely different industries, receive significant cooperation credit under Department policy. 

Specifically, you saw: 

  • Airbus received a 25 percent reduction off the low end of the Guidelines range for its full cooperation in an FCPA case;
  • Herbalife received a 25 percent reduction off the low end of the Guidelines range for its full cooperation in an FCPA case;
  • Novartis and Alcon received 25 percent reductions for their full cooperation in their FCPA cases;
  • Sargeant Marine received a 25 percent reduction off the low end of the Guidelines range for its full cooperation in an FCPA case;
  • And Vitol received a 25 percent reduction off the low end of the Guidelines range for its full cooperation in an FCPA case.

When companies cooperate with the Fraud Section in connection with its investigations and prosecutions, there are benefits.

For one, if criminal liability is established, cooperation may affect the ultimate form of resolution—be it plea agreement, deferred prosecution agreement, or non-prosecution agreement.  

Second, cooperation certainly will affect how much a company is required to pay, or not pay, assuming criminal liability has been established. 

Cooperation reductions can be, and often are, significant—routinely totaling tens of millions of dollars. 

So, cooperation matters. 

And the Fraud Section faithfully applies Department policies on cooperation, crediting it when it happens and taking note when it does not.    

The second point I want to highlight is the importance of coordination, both to the Department and to those we investigate.

Under the Department’s “Anti-Piling On” policy, prosecutors “should [] endeavor, as appropriate, to coordinate with . . . other federal, state, local, or foreign enforcement authorities that are seeking to resolve a case with a company for the same misconduct.”

And at the Fraud Section, we have been clear and consistent in our application of this Department policy. 

This year, we applied the “Anti-Piling On” policy to many of our corporate criminal resolutions. 

These resolutions included cases involving multiple U.S. enforcement authorities and cases involving U.S. and foreign enforcement authorities.

In these coordinated resolutions, we credited certain amounts paid to other authorities. 

In performing our crediting analysis, we carefully considered the equities of the authorities involved as well as the respective national interests of the authorities involved.

And we did so because the offending corporation, in every instance, made a good faith, bona fide effort to coordinate and assist the relevant authorities in achieving a global resolution.

Which brings me to a key point—the difference between what the “Anti-Piling On” policy is, and what it is not.

In our view, the policy is an attempt by the Department to ensure an appropriate and fair outcome for an offending company.

This is achieved, through the policy, by advising Department attorneys to coordinate, as appropriate, with different federal, state, local, or foreign enforcement authorities before resolution to achieve an overall equitable result for the company that avoids unnecessary and unwarranted duplication.

In our view, the policy is not something to be used offensively or tactically by corporations or counsel. 

What I mean by that is that the policy is not intended to be exploited by companies to strategically resolve with other enforcement authorities first, often on an incomplete record and with no acceptance of responsibility or admission of liability.

Only later to be used against the Department in subsequent criminal resolution discussions in support of an argument that any further criminal enforcement action by the Department should be precluded or mitigated because of the prior uncoordinated resolution.  

Unfortunately, on occasion we see just that: attempts to use this policy—one that is meant to protect companies from unfairly duplicative penalties—against the Department. 

Let me also underline one aspect of this policy that may seem obvious but bears special emphasis—coordination requires effort from all sides. 

From the Department, from its enforcement authority counterparts and, of course, from the offending company. 

And to achieve meaningful coordination—indeed, to enable coordination to occur at all—companies must attempt to coordinate with the Department.

If a company wants Section prosecutors to give any weight to a request that they should credit some, or all, of a preceding resolution with another enforcement authority, that coordination, or attempts to coordinate, must occur well before any agreement is reached with another enforcement authority.   

From our perspective, this is how the policy operates, in both theory and practice.

And I hope these remarks offer some helpful clarity on the Fraud Section’s application of this important Department policy.

Before I wrap up, I want to return to something I touched on earlier.

That’s the outstanding work of the women and men of the Fraud Section. 

It’s been the honor and privilege of my professional life to work in the Fraud Section. 

The men and women of the Fraud Section are unrivaled in their talent, dedication, and vision, especially when it comes to white-collar criminal enforcement. 

And of course, their work, and the results they have delivered this year, are all the more remarkable when you consider they have been achieved amid this National Emergency.

Which has forced us, like all of you, to completely rethink and redesign how we do our jobs. 

Nearly everything we do has been impacted by current restrictions. 

Travel.  Face-to-face interviews.  Court proceedings.  Grand jury appearances.  Trials. 

We’ve had to find new, different, and creative ways to accomplish our mission.

But as you can see from the work and figures I mentioned earlier, we have not slowed down. 

If anything, we have ramped up and done more. 

The American people rightly expect much of the Department of Justice, and we in the Criminal Division’s Fraud Section will continue to work each and every day to deliver for them.  

Thank you again for the opportunity to speak with you this morning, and I wish you well with the remainder of your program today. 

More from: December 9, 2020

News Network

  • Business Executive Pleads Guilty in Conduit Campaign Contribution Case
    In Crime News
    A California business executive pleaded guilty today in the District of Columbia for conspiring to make and conceal conduit and excessive campaign contributions during the U.S. presidential election in 2016 and thereafter.
    [Read More…]
  • Jury finds Webster aviation company liable for violating FAA regulations
    In Justice News
    Ascent Aviation [Read More…]
  • Deputy Secretary Sherman’s Visit to the People’s Republic of China
    In Crime Control and Security News
    Office of the [Read More…]
  • [Protest of Contract Award]
    In U.S GAO News
    A firm protested the award of a contract by a firm which the National Aeronautics and Space Administration (NASA) hired to operate a computer complex. The protester contended that: (1) it should not have been excluded from the competitive range; (2) the acceptance of the awardee's proposal effected a material change in the solicitation; and (3) neither NASA nor its contractor obtained a Delegation of Procurement Authority from the General Services Administration prior to issuing the request for proposals and contracting with the awardee. The contractor stated that the protester's proposal was unacceptable because it lacked technical information, was deficient, and could not be evaluated. The protester stated that it should have been included in the competitive range because its proposal took no exceptions to the technical requirements. In addition, it contended that it should not have been excluded for informational deficiencies because the solicitation cautioned offerers against submitting elaborate proposals. GAO found that the contractor's decision to exclude the protester from the competitive range was reasonable. Although the solicitation cautioned against overly elaborate proposals, this did not excuse offerers from discussing their proposals in detail. GAO found that Federal regulations required neither NASA nor its contractor to obtain a Delegation of Procurement Authority. Finally, GAO did not find it necessary to resolve the question of the awardee's cost proposal because, even if the allegation were correct, the protester would not have been entitled to an amendment dealing with cost proposals since it was excluded from the competitive range on the basis of its technical proposal. Accordingly, the protest was denied.
    [Read More…]
  • Justice Department Sues Town of Wolcott, Connecticut, for Discrimination Against Persons with Disabilities
    In Crime News
    The Justice Department today filed a lawsuit alleging that the Town of Wolcott, Connecticut, has discriminated against persons with disabilities in violation of the Fair Housing Act.
    [Read More…]
  • Maryland Accountant Convicted of Preparing False Tax Returns for D.C. Residents
    In Crime News
    A federal jury in the District of Columbia convicted a Maryland woman today for preparing three false tax returns for District of Columbia residents that claimed more than $1.1 million in fraudulent refunds.
    [Read More…]
  • Former Bank Executive Sentenced to Prison for $15 Million Construction Loan Fraud
    In Crime News
    A former Kansas bank executive was sentenced to 60 months in prison today for his role in carrying out a bank fraud scheme to obtain a $15 million construction loan from 26 Kansas banks.
    [Read More…]
  • Financial Audit: Federal Deposit Insurance Corporation Funds’ 2020 and 2019 Financial Statements
    In U.S GAO News
    GAO found (1) the financial statements of the Deposit Insurance Fund (DIF) and of the Federal Savings and Loan Insurance Corporation (FSLIC) Resolution Fund (FRF) as of and for the years ended December 31, 2020, and 2019, are presented fairly, in all material respects, in accordance with U.S. generally accepted accounting principles; (2) although internal controls could be improved, the Federal Deposit Insurance Corporation (FDIC) maintained, in all material respects, effective internal control over financial reporting relevant to the DIF and to the FRF as of December 31, 2020; and (3) with respect to the DIF and to the FRF, no reportable instances of noncompliance for 2020 with provisions of applicable laws, regulations, contracts, and grant agreements GAO tested. In commenting on a draft of this report, FDIC stated that it was pleased to receive unmodified opinions on the DIF's and the FRF's financial statements. In regard to the significant deficiency in internal control over contract payment review processes, FDIC stated that it began taking steps to address this issue and will work to enhance control activities and expand monitoring capabilities in this area. Further, FDIC stated that it recognizes the essential role a strong internal control program plays in an agency achieving its mission. FDIC added that its commitment to sound financial management has been and will remain a top priority. Section 17 of the Federal Deposit Insurance Act, as amended, requires GAO to audit the financial statements of the DIF and of the FRF annually. In addition, the Government Corporation Control Act requires that FDIC annually prepare and submit audited financial statements to Congress and authorizes GAO to audit the statements. This report responds to these requirements. For more information, contact James R. Dalkin at (202) 512-3133 or dalkinj@gao.gov.
    [Read More…]
  • South Carolina Couple Pleaded Guilty to Scheme Involving Conspiracy and False Statements to Illegally Obtain a U.S. Passport
    In Crime News
    A Huger, South Carolina couple pleaded guilty today in South Carolina before the U.S. District Judge Brucie H. Hendricks in the District of South Carolina to charges stemming from their conspiracy to obtain a U.S. passport by falsely claiming they were the biological parents of a baby born in the Philippines and by using false birth records to apply for a U.S. passport for the baby.
    [Read More…]
  • Deputy Secretary Sherman’s Call with OSCE Secretary General Schmid
    In Crime Control and Security News
    Office of the [Read More…]
  • Secretary Antony J. Blinken at a Discussion with Civil Society
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Secretary Blinken’s Meeting with Domestic Refugee Resettlement Agencies
    In Crime Control and Security News
    Office of the [Read More…]
  • Justice Department and EPA Reach Clean Air Act Settlement with Advanced Flow Engineering for Selling Defeat Devices
    In Crime News
    The U.S. Department of Justice (DOJ) and the U.S. Environmental Protection Agency (EPA) announced that Advanced Flow Engineering (aFe), an automotive parts manufacturer and distributor based in Corona, California, has agreed to stop manufacturing and selling parts for motor vehicles that, when installed, defeat, disable or override EPA-approved emission controls and harm air quality.
    [Read More…]
  • The United States Calls for Free, Fair, and Peaceful Elections in Uganda
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • The United States Welcomes the Appointment of Staffan de Mistura as the UN Secretary General’s Personal Envoy for Western Sahara
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Sanctioning Hizballah Financiers in Lebanon
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Opportunity Zones: Census Tract Designations, Investment Activities, and IRS Challenges Ensuring Taxpayer Compliance
    In U.S GAO News
    What GAO Found The 2017 law commonly known as the Tax Cuts and Jobs Act created a tax incentive that gave governors discretion to nominate generally up to 25 percent of their states' low-income census tracts as special investment areas called Opportunity Zones. The U.S. Department of the Treasury then verified eligibility and designated the nominated tracts. GAO found that on average, the selected tracts had higher poverty and a greater share of non-White populations than eligible, but not selected, tracts. These differences were statistically significant. Most state government officials were aware of at least some Opportunity Zone investments but had differing views of the tax incentive's effect so far. State Respondents' Views on Overall Impact of the Opportunity Zones Tax Incentive Note: GAO surveyed government officials from the 50 states, Washington, D.C., and the five U.S. territories—American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands—and received 56 responses. Based on case studies of Qualified Opportunity Funds—investment vehicles organized for investing in Opportunity Zones—the tax incentive attracted investment in a variety of projects, including multifamily housing, self-storage facilities, and renewable energy businesses. According to survey responses and other sources, most projects are real-estate focused. Through 2019, more than 6,000 Qualified Opportunity Funds had invested about $29 billion, based on partial data from the Internal Revenue Service (IRS). IRS developed plans to ensure Qualified Opportunity Funds and investors are complying with the tax incentive's requirements; however, IRS faces challenges in implementing these plans. Specifically, the plans depend on data that are not readily available for analysis. In addition, funds have attracted investments from high-wealth individuals, and some funds are organized as partnerships with hundreds of investors. IRS considers both of these groups to be high risk for tax noncompliance generally. However, IRS has not researched potential compliance risks these groups pose for this tax incentive. As a result, IRS may be unable to effectively direct compliance efforts. Why GAO Did This Study Congress created the Opportunity Zones tax incentive to spur investments in distressed communities. Taxpayers who invest in Qualified Opportunity Funds—that then invest in qualified property or businesses—could receive significant tax-related benefits. Funds and their investors generally must invest in Opportunity Zones for a minimum number of years and report information annually to receive tax benefits and avoid penalties. IRS administers and ensures compliance with these rules. GAO was asked to review implementation and use of this tax incentive. This report describes the process for designating census tracts as Opportunity Zones and compares characteristics of designated and non-designated tracts; describes Qualified Opportunity Funds' experiences with and states' views on the tax incentive; analyzes available IRS data; and evaluates IRS's taxpayer compliance plans, among other objectives. GAO analyzed census data on tracts designated and not designated as Opportunity Zones, analyzed data from a non-generalizable sample of 18 Qualified Opportunity Funds, and surveyed state officials. GAO also reviewed IRS documentation, including a compliance plan, and met with Treasury and IRS officials.
    [Read More…]
  • Secretary Blinken’s Call with Norwegian Foreign Minister Søreide
    In Crime Control and Security News
    Office of the [Read More…]
  • Justice Department Issues Guidance on Federal Statutes Regarding Voting Methods and Post-Election “Audits”
    In Crime News
    Today the U.S. Department of Justice announced the release of two guidance documents to ensure states fully comply with federal laws regarding elections, specifically federal statutes affecting methods of voting and federal constraints related to post-election “audits.”
    [Read More…]
  • Behavioral Health: Patient Access, Provider Claims Payment, and the Effects of the COVID-19 Pandemic
    In U.S GAO News
    What GAO Found GAO found that there have been longstanding concerns about the availability of behavioral health treatment, particularly for low-income individuals. According to a review of federal data, one potential barrier to accessing treatment has been shortages of qualified behavioral health professionals, particularly in rural areas. Stakeholders that GAO interviewed—officials from the National Council for Behavioral Health (NCBH) and from hospital associations and insurance regulators in four states—cited additional contributing factors such as provider reimbursement rates and health system capacity. Additionally, recent reports from Pennsylvania and Oregon further documented longstanding problems with meeting the need for behavioral health services in their states. Evidence collected during the pandemic suggests the prevalence of behavioral health conditions has increased, while access to in-person behavioral health services has decreased: Centers for Disease Control and Prevention (CDC) survey data collected from April 2020 through February 2021 found that the percentage of adults reporting symptoms of anxiety or depression averaged 38 percent. In comparison, using similar questions, CDC found that about 11 percent of U.S. adults reported experiencing these symptoms from January to June 2019. An analysis of CDC data found that the share of emergency department visits for drug overdoses and suicide attempts were 36 and 26 percent higher, respectively, for the period of mid-March through mid-October 2020 compared to the same time period in 2019. In a February 2021 survey of its members, NCBH found that in the 3 months preceding the survey, about two-thirds of the member organizations surveyed reported demand for their services increasing and having to cancel or reschedule patient appointments or turn patients away. The survey also found that during the pandemic, 27 percent of member organizations reported laying off employees, 45 percent reported closing some programs, and 35 percent decreased the hours for staff. Officials GAO interviewed from provider organizations offered anecdotal examples of problems with payments for behavioral health services, including examples suggesting that denials and delays were more common for these services than they were for medical/surgical services. However, most officials were not aware of published data that could confirm their concerns, and data from reports from two states on claims denials either did not support their concerns or were inconclusive. In addition, a report in one state that examined mental health parity—requirements that behavioral health benefits are not more restrictive than medical/surgical benefits—found that the rate of complaints associated with behavioral health services was notably lower than those for medical/surgical services. The lack of available data confirming stakeholder concerns could be related to potential challenges consumers and providers face in identifying and reporting mental health parity violations, as previously reported by GAO. Specifically, in 2019, GAO found that complaints were not a reliable indicator of such violations, because consumers may not know about parity requirements or may have privacy concerns related to submitting a complaint. GAO recommended that the federal agencies involved in the oversight of mental health parity requirements evaluate the effectiveness of their oversight efforts. As of March 2021, the agencies had not yet implemented this recommendation. Why GAO Did This Study Behavioral health conditions, which include mental health and substance use disorders, affect a substantial number of adults in the United States. For example, in 2019, an estimated 52 million adults in the United States were reported to have a mental, behavioral, or emotional disorder, and 20 million people aged 12 or older had a substance use disorder. Experts have expressed concerns that the incidence of behavioral health conditions would increase as a result of stressors associated with the COVID-19 pandemic. Even before the pandemic, longstanding questions have been raised about whether coverage or claims for behavioral health services are denied or delayed at higher rates than those for other health services. GAO was asked to examine several issues about the demand for behavioral health services, as well as coverage and payment for these services. GAO examined (1) what is known about the need for and availability of behavioral health services, and how these have changed during the COVID-19 pandemic; and (2) what issues selected stakeholders identified regarding the payment of claims for behavioral health services. GAO reviewed survey data and other relevant analyses focused on the need for and availability of behavioral health services prior to and during the COVID-19 pandemic. GAO also reviewed reports from two states that compared claims for behavioral health services with those of other health services; interviewed officials from NCBH; and interviewed officials from hospital associations and insurance regulators in Oregon, Pennsylvania, Texas, and Virginia. For more information, contact John E. Dicken at 202-512-7114 or dickenj@gao.gov.
    [Read More…]


Network News © 2005 Area.Control.Network™ All rights reserved.