News & Analysis as of

Fraud and Abuse Whistleblowers Healthcare

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

NAVEX

How Healthcare Organizations Can Strengthen Compliance to Fight Fraud, Waste and Abuse

NAVEX on

Healthcare organizations face an ever-growing list of regulatory demands and risks, with Fraud, Waste, and Abuse (FWA) at the forefront. Addressing FWA is more than avoiding fines under regulations like the False Claims Act –...more

Bradley Arant Boult Cummings LLP

State False Claims and AKS Statutes Keep Case Alive in 2nd Circuit: Underappreciated State Laws May Present Significant Compliance...

Recent years have seen eye-popping judgments and settlements involving cases brought under the federal False Claims Act (FCA) and federal Anti-Kickback Statute (AKS). And healthcare companies have, unsurprisingly, focused...more

Health Care Compliance Association (HCCA)

In Biggest Stark-Based FCA Settlement Ever, Indiana Hospital Pays $345M, Has Unusual CIA

Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more

Proskauer - Health Care Law Brief

Recent Supreme Court Case Affirms Government’s Power to Dismiss Qui Tam Suits

On June 16, 2023, the Supreme Court (the “Court”) in United States ex rel. Polansky v. Executive Health Resources affirmed the federal government’s power to dismiss a False Claims Act (“FCA”) action brought under the qui tam...more

ArentFox Schiff

Investigations Newsletter: Top Reasons for 2022’s Downward Trend in False Claims Act Recoveries

ArentFox Schiff on

Top Reasons for 2022’s Downward Trend in False Claims Act Recoveries - Following the US Department of Justice’s (DOJ) release of statistics regarding FCA settlements and judgments for the 2022 fiscal year, Law360 spoke...more

Polsinelli

False Claims Act Recoveries During 2021

Polsinelli on

On February 1, 2022, the United States Department of Justice (DOJ) announced that it had recovered $5.6 billion from False Claims Act (FCA) Cases during fiscal year 2021. Each year, the DOJ publishes statistics about its...more

Pillsbury Winthrop Shaw Pittman LLP

Bipartisan Spotlight on Medicare Advantage Risk Adjustment Fraud Likely to Spur Audits

Potential fraud and abuse in the Medicare Advantage Program (“MA Program”) has become the focus of two senior-ranking Senators on each side of the aisle—Chuck Grassley (R-Iowa) and Claire McCaskill (D-Mo.)—and this attention...more

Katten Muchin Rosenman LLP

Managing Institutional Risk: Fraud-Proofing Your Organization

In this presentation: - Top 5 Fraud and Abuse Risks Facing Health Systems - Results of Enforcement Action - Top 5 Steps Health Systems Can Take To Minimize Fraud & Abuse Risk - Non-Compliant...more

BakerHostetler

Summer Fraud and Abuse Roundup

BakerHostetler on

The federal government was busy over the summer when it came to decisions and settlements under the Stark Law, anti-kickback law and federal False Claims Act. This article revisits recent developments with respect to...more

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