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Investigations Health Insurance

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

Polsinelli

Five Things Every Health Care Provider Should Know About HHS OIG’s 2025 Semiannual Report

Polsinelli on

On June 2, 2025, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) published its Semiannual Report to Congress. This report covers the period from October 1, 2024, through March 31, 2025,...more

Marshall Dennehey

Do Not Forget the Anesthesia! Investigating the Use of Anesthesia During Common Interventional Pain Management Procedures

Marshall Dennehey on

Interventional pain management treatment frequently begins with a series of epidural and facet injections. These injections are performed in surgical centers and under anesthesia. Billing received is from three parties: the...more

Arnall Golden Gregory LLP

Mental Health Crisis: Unmasking Ghost Networks

As the United States continues to grapple with a growing mental health crisis, millions are finding it increasingly difficult to access and afford mental health treatment. Recent investigations conducted by the New York...more

Faegre Drinker Biddle & Reath LLP

DOL Issues Long Awaited Mental Health Parity Guidance

Plan sponsors, insurers, and third-party administrators should pay close attention to the new guidance to facilitate health plan compliance with complex nonquantitative treatment limitation comparative analyses requirements....more

Akerman LLP - Health Law Rx

FTC Investigating the Competitive Effects of Certificates of Public Advantage

The Federal Trade Commission has issued orders to five health insurers and two health systems requiring them to provide information that will assist the FTC in studying the competitive effects of certificates of public...more

Proskauer - Government Contractor Compliance...

Health Insurer Settles OFCCP Retaliation Allegations for $372,000

A health insurance provider in Massachusetts has agreed to pay $372,739 to resolve an Office of Federal Contract Compliance Programs (OFCCP) investigation into claims of discrimination and retaliation....more

King & Spalding

Insurance Coverage for Healthcare False Claims Act, Stark, and HIPAA/HITECH Government Investigations

King & Spalding on

Federal enforcement of False Claims Act (FCA), Stark anti-kickback, and HIPAA/HITECH claims against healthcare companies continues to rise rapidly. FCA recoveries by the U.S. Department of Justice (DOJ) exceeded $9.5 billion...more

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