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Medicaid › Department of Health and Human Services (HHS) › Enforcement

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Foley & Lardner LLP

DOJ-HHS False Claims Act Working Group: Focus on Medicare Payment Suspensions

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n a July 2, 2025, press release, the U.S. Department of Justice (DOJ) announced a new “DOJ-HHS False Claims Act Working Group” (the Working Group) and identified multiple priority enforcement efforts for the Working Group to...more

Husch Blackwell LLP

DOJ and HHS Launch New False Claims Act Working Group: What The Healthcare Industry Needs to Know

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On July 2, 2025, the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) announced the creation of the DOJ-HHS False Claims Act Working Group, a high-level interagency initiative aimed at...more

Akin Gump Strauss Hauer & Feld LLP

Eliminating Waste, Fraud, and Abuse in Medicaid (Trump EO Tracker)

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This memorandum directs the Secretary of Health and Human Services to take appropriate action to eliminate waste, fraud, and abuse in Medicaid, including by ensuring Medicaid payments rates are not higher than Medicare....more

Mintz

Trump Signs Most-Favored-Nation Executive Order - Potential Impact on Drug Supply Chain

Mintz on

After significant fanfare and anticipation, President Trump issued his “Delivering Most-Favored Nation Prescription Drug Pricing to American Patients” Executive Order (Executive Order) this week. The Executive Order seeks to...more

McDermott Will & Schulte

HHS OIG Releases Updated Nursing Facility Compliance Program Guidance: Quality and Safety Lessons

McDermott Will & Schulte on

Nursing facilities and skilled nursing facilities that participate in the Medicare and Medicaid programs must comply with certain mandatory compliance program requirements of participation (ROPs). Under the Biden...more

ArentFox Schiff

At Long Last, the OIG Issues Its Compliance Program Guidance for Nursing Facilities

ArentFox Schiff on

On November 20, 2024, the US Department of Health and Human Services, Office of Inspector General (OIG) issued its Industry Segment-Specific Compliance Program Guidance for Nursing Facilities (Nursing Facility ICPG)....more

King & Spalding

Texas Sues Federal Government to Protect Medicaid Financing

King & Spalding on

On December 11, 2024, the Texas Health and Human Services Commission filed a complaint in the United States District Court for the Western District of Texas. The complaint seeks to block the enforcement of a May 9, 2014,...more

Foley & Lardner LLP

Health Care Enforcement: “Tea Leaves” in the 2024 National Health Care Fraud Summer Takedown

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Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more

ArentFox Schiff

The 340B ‘Saga’ Continued: HRSA, States, and Drug Manufacturers Contest 340B Contract Pharmacy Restrictions in Court

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In 2021, we provided an overview of multiple federal lawsuits challenging the US Department of Health and Human Services (HHS) Health Resources and Services Administration’s (HRSA) enforcement of the 340B Drug Pricing...more

Holland & Knight LLP

HHS Publishes Final Rule Governing Healthcare Conscience Protections

Holland & Knight LLP on

On Jan. 11, 2024, the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) published its 2024 Final Rule governing healthcare conscience protections, "Safeguarding the Rights of Conscience as...more

Harris Beach Murtha PLLC

OIG’s 2022 Health Care Fraud & Abuse Control Program Report Published

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The Department of Health and Human Services’ (“HHS”) Office of Inspector General (“OIG”) and the Department of Justice (“DOJ”) published their joint Report on the Health Care Fraud and Abuse Control Program for Fiscal Year...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Harris Beach Murtha PLLC

OIG Enforcement Summary: August 16, 2022 – August 31, 2022

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The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more

Harris Beach Murtha PLLC

OIG Enforcement Summary: August 1, 2022 – August 15, 2022

Harris Beach Murtha PLLC on

The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more

Harris Beach Murtha PLLC

Summary of Fraud and Abuse Enforcement Yields Insight for Health Care Compliance and Risk Assessment

Harris Beach Murtha PLLC on

The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more

Sheppard Mullin Richter & Hampton LLP

Clarity on Reporting and Enforcement: CMS Issues Guidance Regarding Hospital COVID-19 Reporting Requirements

Sheppard Mullin Richter & Hampton LLP on

On October 6, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released guidance regarding the requirements and enforcement process for hospital reporting of COVID-19 data elements (the “Guidance”). The Guidance...more

Health Care Compliance Association (HCCA)

[Event] Virtual 2020 New York Regional Conference - May 8th, New York, NY

Health Care Compliance Association (HCCA) on

Regional Virtual Healthcare Compliance Conference Overview - Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your...more

Foley & Lardner LLP

FDA Publishes Enforcement Policies to Address Coronavirus Personal Protective Equipment Shortages

Foley & Lardner LLP on

In the wake of the COVID-19 pandemic, the FDA has sought to expand the availability of needed personal protective equipment (PPE) for the general public and healthcare professionals. Recently, for example, FDA published two...more

Holland & Knight LLP

Healthcare Law Update: May 2018

Holland & Knight LLP on

Enforcement - OIG Issues Advisory Opinion on Provision of Samples by a Device Distributor - On April 30, 2018, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a...more

Baker Donelson

OIG March 2018 Work Plan Update

Baker Donelson on

The OIG's March 2018 Work Plan update included seven items. Not surprisingly, the opioid crisis continues to be an area of focus for the OIG. The OIG also intends to review the oversight of vocational rehabilitation provided...more

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