News & Analysis as of August 21, 2025

Health Care Providers

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Read guidance, analysis, and updates on the myriad issues arising from the global response to the COVID-19 pandemic. Updated hourly every day, the insights published here are written by leading lawyers and law firms helping to make sense of insurance, employment, tax, securities, M&A, risk management, and every other consideration touched by this crisis. Follow the channel for a daily email brief of the latest and best updates. less -

Insights from the Largest DOJ Health Care Fraud Enforcement Effort in U.S. History

Warner Norcross + Judd on 7/9/2025

On June 30, the Department of Justice (DOJ) announced the largest coordinated health care fraud enforcement effort in U.S. history, involving criminal charges against over 300 defendants and over $14.6 billion in health care...more

EnforceMintz — False Claims Act Statistical Year in Review

Mintz - Health Care Viewpoints on 2/4/2025

Health Care Cases Spur Largest FCA Recoveries - Mintz’s annual report on False Claims Act case activity analyzes data from DOJ and the firm’s Health Care Qui Tam Database, and explores the 2024 record high in FCA case...more

Investigations Newsletter: Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions

ArentFox Schiff on 1/13/2025

Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions - In a brief filed earlier this week, the US federal government has urged the Eleventh Circuit Court of Appeals to uphold the...more

True Facts About False Claims: MoFo's FCA Newsletter - July 2024

Morrison & Foerster LLP on 7/25/2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

SDNY Sues Labs For Fraudulent COVID-19 Testing Under False Claims Act

Farrell Fritz, P.C. on 6/28/2024

The SDNY U.S. Attorney’s Office has targeted several labs and their principals for False Claims Act violations arising out of reimbursements for COVID-19 testing services. In a complaint filed on June 13, the government sued...more

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

Morrison & Foerster LLP on 4/25/2024

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Health Care Fraud Enforcement in 2024

Foley Hoag LLP - White Collar Law &... on 4/11/2024

This is the ninth in our 2024 Year in Preview series examining important trends in white collar law and investigations in the coming year... The government had another busy year in 2023 investigating and prosecuting health...more

False Claims Act Settlements and Judgments Near $3 Billion in 2023

Dorsey & Whitney LLP on 3/12/2024

The U.S. Department of Justice (DOJ) announced recently that settlements and judgments under the False Claims Act, 31 U.S.C. § 3729, et seq. (FCA) totaled approximately $2.7 billion in FY 2023 (October 1, 2022 – September 30,...more

DOJ and OIG Actions: 2023 Enforcement Trends Recap

McDermott Will & Schulte on 2/29/2024

This report reviews notable areas for government enforcement actions during 2023 that were discussed in our monthly Healthcare Regulatory Check-Up reports. In the past year, we saw the relevant federal government enforcement...more

FCA Enforcement Remains Fixed on Healthcare and Cybersecurity

Fox Rothschild LLP on 2/28/2024

On February 22, 2024, the U.S. Department of Justice (“DOJ”) released its Fiscal Year 2023 False Claims Act (“FCA”) statistics showing recoveries of almost $2.7 billion. Last year’s recoveries exceeded 2022’s $2.2 billion...more

12th Annual Healthcare Fraud & Abuse Review - A Critical Resource for Healthcare Providers

Bass, Berry & Sims PLC on 2/27/2024

We are pleased to bring you our 12th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more

EnforceMintz — COVID-19 Fraud Enforcement Unlikely to Slow Down in 2024

Mintz on 2/9/2024

The government continued to dedicate enormous resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs in 2023. While we observed some civil False Claims Act settlements, criminal enforcement...more

Healthcare Industry Team 2023 Year in Review

BakerHostetler on 1/19/2024

As we approach the conclusion of another transformative year, we are excited to present our comprehensive year-end review, shedding light on the trends shaping the healthcare market in 2023. Our team’s keen insights and...more

Federal Judge Acquits Physician Following Criminal E/M Fraud Conviction at Trial

Husch Blackwell LLP on 12/29/2023

As previously reported in this post, criminal trials premised on upcoding evaluation and management (E/M) service codes are extremely rare. The Justice Department took that rare step in Maryland in connection with a practice...more

[Event] 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement - January 23rd - 24th, New York, NY

American Conference Institute (ACI) on 11/22/2023

Hosted by American Conference Institute, the 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement returns for another exciting year for lively discussions on FCA enforcement including the ramifications of two...more

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on 8/28/2023

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more

OIG: COVID-19 UIP Overpaid Providers $784M; HRSA Will Recoup Money

Health Care Compliance Association (HCCA) on 8/17/2023

Hospitals and other providers should brace for recoupment of possibly hundreds of millions of dollars they were reportedly overpaid for services provided under the COVID-19 uninsured program (UIP) in the wake of new audit...more

Physicians Beware! Groups Providing DME, Prosthetic Devices, and Other Medical Supplies to Their Medicare Patients Risk Violating...

Epstein Becker & Green on 8/14/2023

When the COVID-19 Public Health Emergency (“PHE”) ended on May 11, 2023, many physician groups furnishing certain medical equipment, devices, and/or supplies to their Medicare patients became in violation of the federal...more

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Health Care Compliance Association (HCCA) on 8/8/2023

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

Investigations Newsletter: Government Brings FCA Action Against Laboratory Companies

ArentFox Schiff on 7/24/2023

Government Brings FCA Action Against Laboratory Companies - On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more

FCA Lawsuit Alleges Three Hospitals Were Overpaid PRF ‘High-Impact’ Money and Kept It

Health Care Compliance Association (HCCA) on 7/18/2023

Report on Medicare Compliance Volume 32, no 25 (July 2023) The former chief hospital executive of Bayonne Medical Center (BMC) in New Jersey has filed a False Claims Act (FCA) lawsuit alleging the hospital and two others...more

Healthcare Regulatory Check-Up Newsletter | May 2023 Recap

McDermott Will & Schulte on 6/23/2023

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA)...more

Government Scrutiny Expected of Providers That Furnished OTC COVID-19 Tests to Medicare Patients

BakerHostetler on 6/12/2023

In April 2022, CMS announced an initiative to pay for Medicare beneficiaries to receive free OTC COVID-19 test kits. Specifically, Medicare established a demonstration project to pay various eligible healthcare providers to...more

Top Takeaways | 2023 Physician Practice Management & ASC Symposium 2023 | Fraud & Abuse Risk Mitigation and Enforcement Trends

McDermott Will & Schulte on 5/26/2023

In this session, McDermott Will & Emery Partners Denise Burke, Tony Maida and Monica Wallace discussed top issues and enforcement trends that physician practice management companies (PPMs) and ambulatory surgery centers...more

While Remote Supervision Remains Available for Direct Supervision, Be Mindful of the Other “Incident to” Requirements

Bass, Berry & Sims PLC on 5/12/2023

With the May 11, 2023 expiration of the federal public health emergency (PHE) for COVID-19, many operational flexibilities healthcare providers used during the PHE will now sunset. Some flexibilities end immediately while...more

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