On July 2, 2025, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) jointly announced the next phase of the Administration’s “Whole-of-Government” approach to fighting health care...more
7/9/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
Enforcement Actions ,
Enforcement Priorities ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
OIG ,
Paycheck Protection Program (PPP) ,
Whistleblowers
On January 15, 2025, the U.S. Department of Justice (DOJ) announced $2.9 billion in total False Claims Act (FCA) recoveries for FY 2024, a slight increase from 2023. In addition to growing recoveries, DOJ announced a new...more
1/20/2025
/ Coronavirus/COVID-19 ,
Cybersecurity ,
Cybersecurity Maturity Model Certification (CMMC) ,
Department of Defense (DOD) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Medicare ,
Medicare Advantage ,
Opioid ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Whistleblowers
The Department of Justice (DOJ) secured another win for its Civil Cyber-Fraud Initiative last week when it resolved a False Claims Act (FCA) action[1] alleging Pennsylvania State University (Penn State) failed to comply with...more
10/29/2024
/ Chief Information Officers (CIO) ,
Compliance ,
Corporate Counsel ,
Cybersecurity ,
Data Breach ,
Department of Defense (DOD) ,
Department of Justice (DOJ) ,
DFARS ,
False Claims Act (FCA) ,
Federal Acquisition Regulations (FAR) ,
Federal Contractors ,
FedRAMP ,
Information Technology ,
Medicare ,
NASA
Years from now, might we cite a recent Middle District of Florida decision as the beginning of the end of the False Claim Act’s (FCA) qui tam provision in its current form? In granting the defendants’ motion for judgment on...more
10/11/2024
/ Department of Justice (DOJ) ,
Executive Powers ,
False Claims Act (FCA) ,
Federal Contractors ,
Healthcare Fraud ,
Medicare ,
Private Actors ,
Qui Tam ,
Relators ,
United States ex rel Polansky v Executive Health Resources Inc ,
Whistleblowers
On February 7, 2023, the Department of Justice (DOJ) announced that FY 2022 yielded just $2.2 billion in spoils from False Claims Act (FCA) judgments and settlements—the smallest haul since 2008 and a precipitous drop from...more
On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more
2/3/2022
/ Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
Federal Contractors ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Information Technology ,
Kickbacks ,
Medicare ,
Misrepresentation ,
Opioid ,
Qui Tam ,
Unnecessary Medical Procedures ,
Whistleblowers
On Friday, August 13, a D.C. Circuit panel unanimously unwound UnitedHealth Group’s (UnitedHealth) successful challenge to the Medicare Advantage Overpayment Rule, determining that the Centers for Medicare and Medicaid...more
The Department of Justice (DOJ) continues to concentrate on risk adjustment programs of payers with Medicare Advantage Organizations (MAO) as a prime enforcement target. One particular area of focus, both civilly and...more
6/14/2021
/ Audits ,
Best Practices ,
Continuing Legal Education ,
Department of Justice (DOJ) ,
Documentation ,
Enforcement Actions ,
Health Care Providers ,
Health Insurance ,
Medical Coding ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Physicians ,
Risk Adjustment Formula ,
Webinars