News & Analysis as of

False Claims Act (FCA) Whistleblowers Insurance Industry

King & Spalding

District Court Orders CVS Caremark to Pay U.S. Government $95 Million

King & Spalding on

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

Rivkin Radler LLP

FCA Case Against Insurers Alleges Kickbacks and Discriminatory Practices

Rivkin Radler LLP on

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

McAfee & Taft

Gavel to Gavel: Justice Department takes aim at private health plan fraud

McAfee & Taft on

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

Goldberg Segalla

Healthcare Insurers Take Note: New Federal Whistleblower Program is Coming for You

Goldberg Segalla on

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

Skadden, Arps, Slate, Meagher & Flom LLP

Privacy & Cybersecurity Update - August 2019

In this month's edition of our Privacy & Cybersecurity Update, we examine the European Parliament's report on whether and how the use of blockchain technology can comply with the General Data Protection Regulation, as well as...more

King & Spalding

California Federal Judge Rules Insurer Not Obligated to Pay Los Angeles Hospital’s $42 Million Settlement and Investigation Costs...

King & Spalding on

On February 12, 2019, U.S. District Court Judge Stephen V. Wilson dismissed a suit brought by Pacific Alliance Medical Center (PAMC) alleging, among other counts, breach of contract against its insurer for failure to cover...more

Carlton Fields

Blowing the Whistle on Willful Misconduct: California Court holds that False Claims Act Suits Are Uninsurable Due to Public Policy

Carlton Fields on

Willful misconduct is uninsurable. It is a fundamental principle of insurance, and it makes sense to both the lay and the lawyerly. But few states go as far as to codify this principle in the insurance code. California is an...more

Carlton Fields

Justice Department Recovers Nearly $6 Billion From False Claims Act Cases in 2014

Carlton Fields on

The U.S. Department of Justice (DOJ) obtained a record $5.69 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2014. This marks the first time the DOJ...more

Carlton Fields

Kane v. Healthfirst and the 60-day Repayment Rule

Carlton Fields on

Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

Burr & Forman

Dodd-Frank News: April 2015: Dodd-Frank Wall Street Reform and Consumer Protection Act Update

Burr & Forman on

The Dodd-Frank Wall Street Reform and Consumer Protection Act was enacted as a measure to promote financial stability and protection for consumers through increased regulation of nearly every aspect of the consumer finance...more

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