News & Analysis as of August 25, 2025

Qui Tam

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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 +

False Claims Act - 2025 Mid-Year Review

Haynes Boone on 7/29/2025

The False Claims Act continues to be one of the most commonly used weapons in the government’s enforcement arsenal to address various forms of fraud. In addition to our “Year in Review” publication providing an overview of...more

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

McAfee & Taft on 12/5/2024

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

Court Finds No Coverage for $42 Million False Claims Act Suit Due To Late Reporting

Carlton Fields on 2/26/2019

A federal court has found no coverage for a $42 million whistleblower settlement due to the insured’s failure to timely report the claim to its carrier. PAMC, Ltd. v. National Union Fire Insurance Company of Pittsburgh, Pa.,...more

EMTALA as a Basis for a Qui Tam Case?

Holland & Knight LLP on 8/7/2018

The Emergency Medical Treatment & Labor Act (EMTALA) requires a hospital with an emergency department (ED) to provide "an appropriate medical screening examination" when an individual comes to the ED and a request is made on...more

Healthcare Fraud & Abuse Review 2017

Bass, Berry & Sims PLC on 3/13/2018

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Millennium Health to Pay $256 million in False Claims Act Settlement

Polsinelli on 11/3/2015

Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”). The Settlement...more

Seventh Circuit Limits the Use of the Federal Assignment Law under the False Claims Act

Foley & Lardner LLP on 12/1/2014

It’s common in the healthcare industry for large insurers to negotiate discounts from pharmacies for prescription drugs. The federal government, the granddaddy of all insurers, does this too, when it negotiates discounts on...more

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