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Department of Justice (DOJ) Coronavirus/COVID-19 Centers for Medicare & Medicaid Services (CMS)

Wiley Rein LLP

DOJ Health Care Fraud Takedown and FCA Working Group Signal New Era of Enforcement and Compliance Risks

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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

Rivkin Radler LLP

Lab Co-Owners Acquitted in Alleged COVID-19 Testing Scheme

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A Florida jury recently found two laboratory co-owners of Innovative Genomics LLC (“IGX”) not guilty in connection with an allegedly fraudulent COVID-19 testing scheme. The Government alleged that from November 2019 through...more

Lowenstein Sandler LLP

In Trump’s Second Term, Healthcare Enforcement May Remain Business as Usual

Compared with other issues, healthcare enforcement during President-elect Donald Trump’s upcoming second term has received little attention. When he takes office again on January 20, should industry actors like pharmaceutical...more

Foley & Lardner LLP

HRSA Uninsured Program COVID-19 Services: What Were the Standards to Determine Uninsured Status?

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The Health Resources and Services Administration (HRSA) Uninsured Program (UIP), which reimbursed providers for provision of COVID-19 related services to uninsured individuals, paid out more than $24.5 billion in claims....more

Health Care Compliance Association (HCCA)

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

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

Health Care Compliance Association (HCCA)

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

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

BakerHostetler

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

BakerHostetler on

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

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | April 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for April 2023. We discuss several criminal and civil enforcement actions related to the Anti-Kickback Statute (AKS) and the...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | January 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity and developments occurring in January 2023, including several criminal and civil enforcement actions related to the federal...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

ArentFox Schiff

10 Legal Challenges for the Health Care Industry in 2023

ArentFox Schiff on

With the new year underway, the ArentFox Schiff Health Care team highlights 10 of the most pressing legal issues facing the industry in 2023. End of the COVID-19 Public Health Emergency. After being in effect for more than...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

King & Spalding

Group of Agency Inspectors General Publishes Report on Program Integrity Risks Across Certain Health Care Programs During the...

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On December 1, 2022, the Pandemic Response Accountability Committee (PRAC) Health Care Subgroup published a report about the use of telehealth in selected health care programs across six federal agencies during the first year...more

Verrill

The PHE is Ending: Do You Know Where Your Waivers Are?

Verrill on

While the pandemic is not over, the COVID-19 public health emergency (PHE) is expected to expire soon, which means that a number of operational, safety, and billing standards that were waived at the beginning of the pandemic...more

Holland & Knight LLP

HHS OIG Provides Clarity on Telemedicine Arrangements

Holland & Knight LLP on

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) published a Special Fraud Alert (Fraud Alert) on July 20, 2022, warning healthcare providers "to exercise caution when entering into...more

Greenbaum, Rowe, Smith & Davis LLP

DOJ and Federal Law Enforcement Agencies Coordinate Efforts in Expanded Pursuit of Healthcare-Related COVID-19 Fraud

What You Need to Know •The federal government is broadening its multi-agency law enforcement effort to address pandemic-related fraud beyond PPP-related cases to encompass alleged instances of healthcare-related COVID-19...more

McDermott Will & Schulte

DOJ Demonstrates Commitment to COVID-19-Related Healthcare Enforcement with New Criminal Charges

On April 20, 2022, the US Department of Justice (DOJ) announced a nationwide coordinated law enforcement action focused on COVID-19-related healthcare fraud. In total, DOJ brought criminal charges against 21 individuals,...more

Mintz - Health Care Viewpoints

DOJ Announces Another Wide-Ranging COVID-19 Fraud Enforcement Action

For the last few years, we have been closely monitoring and reporting on COVID-19 related fraud enforcement efforts by federal agencies. We detailed those findings in our Health Care Enforcement 2020 Year in Review & 2021...more

Rivkin Radler LLP

21 Charged in Federal COVID-19 Fraud Sweep

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On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal...more

King & Spalding

COVID-19 Health Care Fraud Enforcement on the Rise: What’s Ahead for the Life Sciences & Healthcare Industries

King & Spalding on

On April 20, 2022, the Department of Justice (“DOJ”) announced twenty-one (21) defendants were charged in nine (9) different districts related to $149 million in COVID-19-related false billing issues. $8 million in cash and...more

ArentFox Schiff

DOJ Brings Charges Against 21 People in $150 Million COVID-19 Fraud Action

ArentFox Schiff on

The DOJ announced charges against 21 people across nine federal districts for their alleged role in pandemic-related fraud schemes resulting in over $149 million in false billings to federal programs. This is the largest...more

McDermott Will & Schulte

McDermott’s Healthcare Enforcement Quarterly - Q1 2022

The healthcare enforcement landscape is shifting quickly. This issue of McDermott’s Healthcare Enforcement Quarterly examines emerging trends and key issues for organizations that may become subject to enforcement scrutiny,...more

Steptoe & Johnson PLLC

DOJ Continues to Target Health Care Companies - False Claims Act Settlements and Judgments in Fiscal Year 2021

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The Department of Justice recently reported that in fiscal year 2021, it received more than $5.6 billion in settlements and judgments. Of that total, over $5 billion relates to matters that involved the health care industry....more

Tucker Arensberg, P.C.

2022 Federal Compliance Enforcement Outlook

Tucker Arensberg, P.C. on

There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas: ..The use of fraudulently obtained COVID relief funds in both healthcare and in general, but specifically as...more

Sheppard Mullin Richter & Hampton LLP

Day One Notes for the 40th Annual J.P. Morgan Healthcare Conference, 2022

For those of you who know me, I like to have fun with my Zoom backgrounds – choosing photos of interesting scenery or changing them mid-call to reflect my mood or negotiating strategy. Sitting in front of my computer this...more

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