HHS Policy Changes, Supreme Court Rulings, and the DOJ-HHS False Claims Act Working Group
New DOJ Memo Warns Employers: Rethink DEI Programs Now - #WorkforceWednesday® - Employment Law This Week®
Compliance into the Weeds: Two Cyber Security Cases for the Compliance Professional
False Claims Act Insights - Beyond Adversarialism: How to Steer FCA Investigations
Work This Way: A Labor & Employment Law Podcast | Compliance Clarity for Federal Contractors with Joan Moore and Mim Munzel of Arbor Consulting Group
Great Women in Compliance: LATAM Compliance Update with Alejandra Montenegro Almonte
AI and the False Claims Act
False Claims Act Insights - The Mathematics of Nuclear FCA Verdicts
Episode 379 -- Update on False Claims Act and Customs Evasion Liability
Everything Compliance: Episode 157, The Q2 2025 Great Women in Compliance Edition
Great Women in Compliance: The Compliance Influencer with Bettina Palazzo
Blowing the Whistle: What Employers Should Know About DEI & the False Claims Act
When DEI Meets the FCA: What Employers Need to Know About the DOJ’s Civil Rights Fraud Initiative
False Claims Act Insights - Bitter Pills: DOJ Targets Pharmacies for FCA Enforcement
False Claims Act Insights - Will Recent Leadership Changes Lead to FCA Enforcement Policy Changes?
Enforcement Priorities of the Second Trump Administration: The False Claims Act
Episode 372 -- DOJ Applies False Claims Act to Tariff and Trade Violations
False Claims Act Insights - How Payment Suspensions Can Impact FCA Litigation
False Claims Act Insights - Trump DOJ Sharpens Its Focus on Healthcare Fraud
False Claims Act Insights - DOJ’s Reliance on FCA to Pursue Covid-Related Fraud
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
On June 25, 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a ruling in the case of U.S. ex rel. Sarah Behnke v. CVS Caremark Corp. et al., ordering CVS...more
On May 14, 2025, Pennsylvania State Sen. Tim Kearney and State Rep. Lisa Borowski introduced legislation addressing private equity and corporate interests in healthcare. Pennsylvania Gov. Josh Shapiro is touting the companion...more
On May 1, the federal government brought a False Claims Act (“FCA”) suit against three health insurers, as well as three insurance brokers. The Justice Department’s suit alleges that the insurers paid millions of dollars in...more
On May 1, a whistleblower filed a complaint under the federal False Claims Act (FCA) against Aetna, Elevance Health (formerly Anthem) and Humana alleging that the insurers paid hundreds of millions of dollars in illegal...more
Early signs from the initial months of the Trump administration indicate that fraud and abuse enforcement related to the Medicare Advantage program (“MA”) remains a bipartisan focus, as evidenced by the recent statements from...more
Likely due to the tremendous number of healthcare mergers, acquisitions, and private equity deals that have been taking place, the industry has recently been the target of multistate unclaimed property audits. This increased...more
On December 23, 2024, various Aetna affiliates (referred to hereafter as Aetna) filed suit against Radiology Partners, Inc., a national, private-equity-backed radiology group, alleging that Radiology Partners defrauded the...more
A recent decision by a federal court in the Eastern District of New York illustrates how directors and officers (“D&O”) policies can provide valuable insurance coverage for defense costs and potential liabilities arising from...more
Historically, the U.S. Department of Justice has directed its efforts on combatting healthcare fraud by focusing on persons and companies who defraud or attempt to defraud federally funded healthcare programs, such as...more
Late this past summer, the Department of Justice (DOJ) launched a new initiative to crackdown on corporate misconduct. Beginning August 1, whistleblowers can submit original information to the DOJ regarding various types of...more
The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more
Here’s what we discuss in our October Insurance Update. Illinois: Environmental Suits Alleging Non-Compliance with Laws and Regulations Did Not Assert an “Occurrence”- Massachusetts (federal): Insurer May Consider Sums...more
The Delaware Supreme Court has held that a professional services exclusion in a D&O policy does not bar coverage for a False Claims Act settlement. In 2017, a former employee of the insured mortgage loan company brought a...more
In its June 14, 2023, decision in United States ex rel. Michelle Calderon v. Carrington Mortgage Services, LLC, No. 22-1553, 2023 WL 3991013, (7th Cir. 2023), the Seventh Circuit explained the high bar for relators to prove...more
The United States Court of Appeals for the Seventh Circuit, applying Illinois law, has held that a $100 million settlement between the United States government and a pharmaceutical company for claims arising under the False...more
On May 3, 2023, the Seventh Circuit affirmed $10 million in insurance coverage for a False Claims Act (FCA) settlement in a case based on alleged Anti-Kickback Statute violations. Astellas US Holding, Inc. v. Federal...more
Additional insured disputes can sometimes get complicated. How much coverage the additional insured gets is often a hotly contested issue, especially when the named insured has coverage above the minimum limits it promised...more
An insurer in Washington could not eliminate its coverage obligation based on its insured’s recovery from a third party. T-Mobile USA, Inc. v. Steadfast Ins. Co., et al., No. 82704-9-I, 2022 WL 17246715 (Wash. Ct. App., Nov....more
The Northern District of Illinois has held that claims brought under the Illinois False Claims Act (“IFCA”) are not uninsurable as a matter of Illinois law. The insured, a telecommunications company with $2 million in...more
In previous posts, we have emphasized the continued judicial trend rejecting insurer arguments that losses purportedly sounding in restitution or disgorgement are “uninsurable” under D&O policies. Despite that trend, insurers...more
A recent coverage case from Illinois is a helpful reminder to policyholders that they should not take no for an answer when insurers deny a claim based on uninsurability, restitution, disgorgement, or fraud. In fact, those...more
Applying Georgia law, a federal district court has held that an insured’s failure to seek consent to incur defense costs pursuant to a consent provision relieved the insurer from any obligation to provide coverage for those...more
Here’s our October Insurance Update. The Sixth Circuit had insurance on its mind this past month. Three of the decisions we discuss in our update are from that court. First, the Sixth Circuit joins the Eighth and...more
Pharmacy Owner and Accountant Indicted in $134m Health Care Fraud Scheme - Mohamed Mokbel and Fathy Elsafty, of Houston, Texas, were arrested on charges of money laundering, health care fraud, and conspiracy to commit...more