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Department of Justice (DOJ) Health Insurance

Cooley LLP

‘Whole-of-Government Approach’ Targets Healthcare Fraud From Every Angle

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Just months after the US Department of Justice (DOJ) designated healthcare fraud as one of its key criminal enforcement priorities, two recent announcements underscore the federal government’s continued focus on combating...more

Haynes Boone

False Claims Act - 2025 Mid-Year Review

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The False Claims Act continues to be one of the most commonly used weapons in the government’s enforcement arsenal to address various forms of fraud. In addition to our “Year in Review” publication providing an overview of...more

Ropes & Gray LLP

Hospital and Health Systems Reimbursement Check July 2025

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In the early days of the second Trump Administration, several federal funding agencies announced caps to indirect cost (“IDC”) rates for federally funded research awards. In many cases, these caps would substantially reduce...more

Vedder Price

DOJ Charges 324 Defendants in Unprecedented Health Care Fraud Takedown

Vedder Price on

On June 30, 2025, the Department of Justice (DOJ) filed criminal charges against 324 defendants across the country alleging participation in various health care fraud schemes. The DOJ identified the operation as the 2025...more

Epstein Becker & Green

The First National Health Care Fraud Takedown of the Second Trump Administration: What Stayed the Same and What is New?

Epstein Becker & Green on

On June 30, 2025, the U.S. Department of Justice (“DOJ”), together with the U.S. Department of Health and Human Services Office of Inspector General (“HHS OIG”) and other law enforcement partners, announced the results of the...more

Sheppard Mullin Richter & Hampton LLP

DOJ and HHS Announce Joint False Claims Act Working Group and Enforcement Priorities

On July 2, 2025, the Departments of Justice and Health & Human Services announced a joint working group aimed at “strengthening their ongoing collaboration to advance priority enforcement areas” under the False Claims Act...more

Ropes & Gray LLP

[Podcast] Medicare Advantage: Enforcement Activity & Broker Arrangements

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On this Ropes & Gray podcast, health care partner Michael Lampert and counsel Sam Perrone are joined by litigation & enforcement partner Andrew O’Connor for a two-part discussion, with this first episode focused on recent...more

Arnall Golden Gregory LLP

New Administration Continues Focus on Accountability and Transparency in Healthcare

Blockbuster health insurers continue to face scrutiny from the new administration amid an unprecedented shift toward eliminating fraud, waste, and abuse from the healthcare industry....more

Seyfarth Shaw LLP

Supreme Court Upholds Tennessee Transgender Care Ban

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In a widely awaited for decision, the Supreme Court in a 6-3 opinion authored by Justice Roberts held that a Tennessee law which prohibits certain medical treatments (puberty blockers and hormones) for transgender minors,...more

Troutman Amin LLP

SCAMMERS OR DUMMIES?: Selling Limited Benefits Plans to Consumers Seeking Health Insurance Lands Four Dudes In Hot Water–BUT Are...

Troutman Amin LLP on

The lead generation industry is fascinating. If there is one over arching mantra it is this– monetize all data available. And sometimes that can get folks into BIG trouble, especially when lead buyers end up pitching...more

Arnall Golden Gregory LLP

Health Insurers Under Fire: New Administration Cracks Down on Evasive Pricing Practices

Health insurance regulations are rapidly shifting with unprecedented intensity. Amid growing public outrage over evasive and abusive pricing practices by insurers and years of federal underenforcement, the new administration...more

McDermott Will & Emery

Enforcement of Mental Health Parity Regulations Suspended: Takeaways for Plan Sponsors and Health Insurance Issuers

McDermott Will & Emery on

In January 2025, The ERISA Industry Committee (ERIC) filed a complaint against the US Departments of Labor, Health and Human Services, and the Treasury (the departments) seeking to invalidate the 2024 final regulations under...more

Ankura

Quarterly Healthcare Transactions Review: Unveiling the Latest Industry Mergers and Acquisitions

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Ankura is pleased to present an overview of healthcare services transactions announced or closed during Q4 2024 in the United States. Total transactions decreased by 10.4 percent in the fourth quarter of 2024 after decreasing...more

Holland & Knight LLP

Holland & Knight Health Dose: May 6, 2025

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Reconciliation markups in the U.S. House of Representatives Committee on Energy and Commerce, as well as the House Committee on Ways and Means, were expected to be held this week but have been postponed until next week at the...more

The Volkov Law Group

DOJ Adopts Aggressive Stance Against Algorithmic Coordination in Multiplan Antitrust Filing

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Recently, the Antitrust Division of the United States Department of Justice submitted a Statement of Interest in In re: Multiplan Health Insurance Provider Litigation, a class action presently pending before the United States...more

Arnall Golden Gregory LLP

DOJ Submits Statement of Interest in MultiPlan Provider MDL

On March 27, 2025, the Department of Justice (“DOJ”) submitted a Statement of Interest in the multidistrict litigation, In re MultiPlan Health Insurance Provider Litigation. The litigation asserts that MultiPlan (now known as...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Crossover Day Wrap-Up - March 2025

As lawmakers and lobbyists shake out the cobwebs from a Crossover Day that ran late into Thursday night, we’re pouring back over what was done and left undone. This special #GoldDomeReport provides a Crossover Day wrap-up of...more

Polsinelli

Back to Backlog? Polsinelli Shareholders Share Insight on how Terminations of DAB Attorneys and Potential Removal of...

Polsinelli on

As the new administration continues its efforts to contract and streamline the federal government, recent developments at the U.S. Department of Health and Human Services (“HHS”) and the Department of Justice (“DOJ”) hint at...more

McDermott+

McDermott+ Check-Up: March 7, 2025

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Government Funding Deadline, Healthcare Program Expirations Approach. Following recent House and Senate passage of their competing budget resolutions, Congress’ attention has now turned to the March 14, 2025, government...more

Troutman Pepper Locke

DOJ and 18 States Reach False Claims Act Settlement with QOL

Troutman Pepper Locke on

The U.S. Department of Justice (DOJ) and 18 state attorneys general (AG) announced a settlement with Boston-based QOL Medical, LLC (QOL) and its CEO, Frederick Cooper, to resolve allegations that the company provided unlawful...more

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

Quarles & Brady LLP on

On December 11, 2024, a bill was introduced in the U.S. House of Representatives that, if enacted, would have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country. Titled the...more

McCarter & English, LLP

Healthcare Consolidation and Private Equity: Public Input on Antitrust Healthcare Regulations

The Department of Justice Antitrust Division (DOJ), the Federal Trade Commission (FTC), and the Department of Health and Human Services (HHS) (together the Agencies) launched a cross-government agency request for information...more

Seyfarth Shaw LLP

Executive Order on Health Care Access for Gender-Affirming Treatments for Minors

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Following through on a campaign theme focused on transgender issues and access to gender-affirming health care, on Friday, January 28, President Trump signed an Executive Order, titled “Protecting Children from Chemical and...more

Health Care Compliance Association (HCCA)

Private-pay “crime stoppers”: Digesting the Corporate Whistleblower Awards Pilot Program

The U.S. Department of Justice’s (DOJ) Criminal Division launched its Corporate Whistleblower Awards Pilot Program (“Criminal Whistleblower Program”) in August of 2024 to encourage tips for various types of fraud, including...more

Mintz - Health Care Viewpoints

Health Care Enforcement Trends & 2025 Outlook

In our annual report, we examine health care enforcement trends, predict how health care enforcement may evolve, and offer practical guidance about what these trends and predictions mean for health care providers, payors, and...more

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