News & Analysis as of

False Billing Medical Reimbursement Enforcement Actions

Troutman Pepper Locke

New York AG Intensifies Investigation and Enforcement Against Alleged Medicaid Fraud

Troutman Pepper Locke on

On June 30, 2025, New York Attorney General (AG) Letitia James announced new lawsuits, criminal charges, and settlements with 25 New York transportation companies related to alleged schemes to defraud Medicaid of millions....more

Pullman & Comley - Connecticut Health Law

Short Staffing May Still be Hindering Health Care in Connecticut but OIG's Exclusion Authority Remains Alive and Well

Can a 40-year-old fraud and abuse law that compared to many others is relatively straightforward still get providers into trouble?  Answer: You bet!  In fact, in the first quarter of 2022 alone, the U.S. Attorney for the...more

Polsinelli

As DOJ Focuses on Medicare Advantage Reimbursement, So Should Health Care Providers

Polsinelli on

Over the past year, the federal government has taken concrete steps to fulfill its promise of a heightened commitment to investigating and enforcing health care fraud within the Medicare Advantage program (Medicare Part C). ...more

Vinson & Elkins LLP

DOJ Intervenes in Another Medicare Advantage FCA Suit

Vinson & Elkins LLP on

On September 13, 2021, the Department of Justice (“DOJ”) intervened in a False Claims Act (“FCA”) suit alleging that a health insurer defrauded the government by submitting false patient data to wrongfully inflate payments...more

Bass, Berry & Sims PLC

FCA Medical Necessity Cases May Stand on Firmer Footing After Recent Appellate Decisions

Bass, Berry & Sims PLC on

In recent years, healthcare providers have increasingly faced civil and criminal enforcement actions premised on the allegation that services billed to government healthcare programs were not medically necessary. As a result,...more

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