News & Analysis as of

Enforcement Actions Healthcare Fraud Criminal Investigations

King & Spalding

Ninth Circuit Decision Clarifies EKRA Enforcement

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On July 11, 2025, the Ninth Circuit issued a decision clarifying the scope of Eliminating Kickbacks in Recovery Act (EKRA). In affirming a Northern California-based medical testing laboratory’s convictions under EKRA, the...more

Cole Schotz

“First Do No Harm” Considerations for Healthcare Providers in Light of Historic Healthcare Fraud Enforcement Announcement by the...

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On Monday, the Department of Justice Criminal Division, led by Matthew R. Galeotti, announced its largest healthcare fraud enforcement charging individuals and entities across the globe in allegedly $14.6 billion criminal and...more

WilmerHale

HHS Office of Inspector General Issues First Semiannual Report to Congress in this Administration

WilmerHale on

On June 2, 2025, the Department of Health and Human Services Office of Inspector General (HHS-OIG) announced the release of its Spring 2025 Semiannual Report to Congress. Covering the period from October 1, 2024, to March 31,...more

Foley Hoag LLP

DOJ Announces New Priorities in White-Collar Criminal Enforcement: Targeting Waste, Fraud, and Abuse and Protecting American...

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The U.S. Department of Justice’s ("DOJ") Criminal Division recently issued a memorandum outlining a shift in the DOJ’s priorities and policies for prosecuting white-collar crime (the “Memorandum”). Issued by the Head of the...more

DarrowEverett LLP

The DOJ’s New White-Collar Agenda: Implications for Businesses

DarrowEverett LLP on

On May 12, 2025, the Department of Justice (the “DOJ”) released its criminal—and, more specifically, white collar crime enforcement—initiatives under the current administration. This is typical each time new leadership...more

Health Care Compliance Association (HCCA)

The Latest on Healthcare Enforcement

Healthcare enforcement is never quiet. There’s always something, or many things, going on, and compliance teams need to stay on top of the trends to ensure that their programs are staying ahead of the risks. To find out...more

Maynard Nexsen

Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 186: White Collar Crimes in Healthcare with Maynard...

Maynard Nexsen on

This week, Heather and Lauren welcome more members of the Maynard Nexsen team, White Collar attorneys Erica Barnes, Mark Moore, and Christian Dysart. The group takes a deep dive into discussing white-collar crime in the...more

Oberheiden P.C.

Recent DOJ Consumer Protection Branch Cases Highlight the Branch’s Enforcement Priorities

Oberheiden P.C. on

The U.S. Department of Justice’s (DOJ) Consumer Protection Branch works with other branches and federal law enforcement agencies to investigate and prosecute civil and criminal violations of the nation’s consumer protection...more

Robinson+Cole Health Law Diagnosis

The DOJ Continues to Prosecute Providers for Fraudulent Telemarketing and Telehealth

A physician in Washington state pled guilty on September 28, 2022, to a criminal charge of conspiring to accept kickbacks related to fraudulent genetic testing. According to the Department of Justice (DOJ), the physician...more

Bradley Arant Boult Cummings LLP

DOJ Brings False Claims Act Suit Against Serial LTC Whistleblower

Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more

Polsinelli

Another Wave of Criminal Charges Brought in COVID-Related Fraud

Polsinelli on

The Department of Justice and the US Attorney offices around the country are continuing to be in hot pursuit of cases of fraud related to the COVID-19 pandemic. On April 20, 2022, the Department of Justice announced a new...more

Brownstein Hyatt Farber Schreck

Health Care Fraud Cases Shatter Records

As predicted, health care fraud enforcement under the False Claims Act (“FCA”) continues to be a top priority for the Department of Justice (“DOJ”). In fiscal year 2021, the DOJ obtained more than $5.6 billion in settlements...more

The Volkov Law Group

DOJ Continues Pace of Healthcare Fraud False Claims Act Prosecutions

The Volkov Law Group on

False Claims Act prosecutions continue against healthcare executives, physicians and professionals.  Last year, DOJ recovered over $5.6 billion in FCA enforcement. DOJ expects total recoveries to increase in 2022.  Over 95...more

Morgan Lewis

DOJ Ramping Up Fraud Enforcement Efforts: 2021 Year in Review Report

Morgan Lewis on

The US Department of Justice’s Criminal Division Fraud Section released its annual Year in Review report on February 15, covering 2021. Despite ongoing aftershocks associated with the global pandemic, this year’s report...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Indicted For $100 Million Health Care Fraud Scheme

ArentFox Schiff on

Lab Owner Indicted For $100 Million Health Care Fraud Scheme - On November 2, 2021, a federal grand jury in the Western District of Arkansas indicted Billy Joe Taylor of Arkansas for an alleged health care fraud scheme. ...more

The Volkov Law Group

False Claims Investigations and Criminal Prosecutions: Recent Examples of Criminal Charges – a Lab Owner, A Physician and a Nurse...

The Volkov Law Group on

A False Claims Act case can easily turn into a criminal prosecution.  The Federal Bureau of Investigation often initiates criminal investigations as part of its commitment to reducing health care fraud....more

McDermott Will & Schulte

The Next Wave of COVID-Related Criminal And Civil Enforcement Actions Is Starting

Given the rapid pace and volume of economic aid allocated by Congress to combat the COVID-19 pandemic and its economic impacts, it is no surprise that the federal government has focused heavily on identifying and prosecuting...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2020

Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more

Polsinelli

DOJ Creates National Rapid Responce Strike Force As Focus On Health Care Fraud Continues To Grow

Polsinelli on

As COVID-19 continues to ravage the United States, the Department of Justice (DOJ) has recently announced its new National Rapid Response Strike Force within the Health Care Fraud Unit to investigate and prosecute fraud cases...more

Polsinelli

DOJ Creates National Rapid Response Strike Force As Focus on Health Care Fraud Continues to Grow

Polsinelli on

As COVID-19 continues to ravage the United States, the Department of Justice (DOJ) has recently announced its new National Rapid Response Strike Force within the Health Care Fraud Unit to investigate and prosecute fraud cases...more

Troutman Pepper Locke

It’s All Hands on Deck in Prosecuting COVID-19 Fraud

Troutman Pepper Locke on

As scientists around the globe team up to discover and develop treatments and vaccine candidates for COVID-19, we are also seeing unprecedented speed and coordination in the effort to quell a different kind of virus — the...more

ArentFox Schiff

Investigations Newsletter: Michigan Physician Charged in Alleged Role in Health Care Fraud and Money Laundering Conspiracy

ArentFox Schiff on

Michigan Physician Charged in Health Care Fraud and Money Laundering Conspiracy - On February 26, 2020, the Department of Justice announced charges against a Michigan physician for his alleged role in an over $120 million...more

Bricker Graydon LLP

EHR vendor Practice Fusion agrees to $145 million settlement to resolve criminal and civil kickback violations

Bricker Graydon LLP on

On January 27, 2020, the Department of Justice (DOJ) announced a $145 million settlement with electronic health record (EHR) vendor Practice Fusion to resolve civil and criminal allegations that it violated the Anti-Kickback...more

Mintz - Health Care Viewpoints

Health Care Enforcement Year-in-Review and 2020 Outlook: Criminal Case Developments

As discussed in our article recently published by Law360, criminal health care enforcement in 2019 was in many ways a continuation of 2018, with opioid-related enforcement continuing to be the clear top priority for the...more

ArentFox Schiff

Investigations Newsletter: DOJ Issues Guidance on Ability-to-Pay in False Claims Act Cases

ArentFox Schiff on

DOJ Issues Guidance on Ability-to-Pay in False Claims Act Cases - On October 8, 2019, Assistant Attorney General Brian Benczkowski announced new guidance for federal prosecutors evaluating whether a corporation is unable...more

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