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Medicaid › Settlement

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 -
Haynes Boone

False Claims Act - 2025 Mid-Year Review

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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

Epiq

When Treatment Costs Exceed Settlements

Epiq on

Navigating the complex landscape of lien resolutions in mass torts is a challenge for both plaintiffs’ and defense attorneys. One of the biggest hurdles is complying with federal and state regulations to resolve health care...more

Cozen O'Connor

AGs Inject Accountability into Pharma Practices via $202M Gilead Settlement

Cozen O'Connor on

New York AG Letitia James, along with a bipartisan coalition of 48 other AGs and in coordination with the U.S. DOJ, announced a $202 million settlement in principle with Gilead Sciences, Inc. (“Gilead”), to resolve...more

Troutman Pepper Locke

New York AG Intensifies Investigation and Enforcement Against Alleged Medicaid Fraud

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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

Pietragallo Gordon Alfano Bosick & Raspanti,...

An Emerging Opportunity for the States to Revitalize Their State False Claims Act Enforcement

Pietragallo Gordon Alfano Bosick & Raspanti,... on

While the Trump administration replaces all of the United States Attorneys, as well as many senior-level positions at the Department of Justice, stakeholders will soon be able to evaluate civil enforcement priorities under...more

Robinson+Cole Health Law Diagnosis

False Claims Act Enforcement of Pharmacy Pricing & Prescribing Practices: The Walgreens Cases

Robinson+Cole Health Law Diagnosis on

The Department of Justice has launched a number of enforcement actions targeting pharmacies for alleged violations of the False Claims Act (FCA). Recently, Walgreens has been the subject of two noteworthy government...more

Offit Kurman

When the Settlement Threatens the Safety Net: Legal Strategies for Protecting Benefits

Offit Kurman on

As an estate planning attorney practicing in Pennsylvania with a strong focus on special needs planning, I frequently work alongside personal injury counsel to address a critical but often overlooked consequence of...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Recent False Claims Act Settlement Should Put Treatment Centers on Notice

Pietragallo Gordon Alfano Bosick & Raspanti,... on

Late last month, the federal government announced a False Claims Act settlement with Summit BHC New Jersey, LLC, d/b/a Seabrook (“Seabrook”), a prominent New Jersey Drug & Alcohol Rehabilitation facility. The joint settlement...more

ArentFox Schiff

Investigations Newsletter: Seabrook Rehab Center to Pay $19.75 Million for FCA Violations

ArentFox Schiff on

Seabrook Rehab Center to Pay $19.75 Million for FCA Violations - A New Jersey drug and alcohol rehabilitation center, Seabrook, will pay $19.75 million to resolve allegations that it violated the False Claims Act (FCA) by...more

Lowenstein Sandler LLP

Two False Claims Act Cases From SDNY Highlight Continuing Bite of Aggressive Healthcare Enforcement

Lowenstein Sandler LLP on

The U.S. Attorney’s Office for the Southern District of New York last week announced the resolution of two significant False Claims Act (FCA) cases—one from a large settlement and the other the result of a jury verdict after...more

Perkins Coie

First Circuit Imposes Higher “But-for” Causation Standard for False Claims Act Liability Based on Alleged Anti-Kickback Statute...

Perkins Coie on

On February 18, 2025, the U.S. Court of Appeals for the First Circuit added its voice to a growing chorus of appellate courts to elevate the standard of proof required to show a violation of the federal False Claims Act in...more

Epiq

How Plaintiff and Defense Attorneys Can Protect Beneficiaries’ Finances and Health Care in MMSEA Section 111 Reporting

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Insufficient collaboration between plaintiff and defense attorneys regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting requirements creates administrative complications which can negatively...more

Cozen O'Connor

Texas AG Settles for $40 Million Over Medicaid Fraud Allegations

Cozen O'Connor on

Texas AG Ken Paxon announced a settlement with Molina Healthcare of Texas, Inc. and Molina Healthcare, Inc. (collectively, “Molina”), to resolve allegations of Medicaid fraud. The AG’s office claims Molina violated the Texas...more

Cozen O'Connor

Walgreens Settles With 50 AGs and U.S. DOJ Over Allegedly Billing for Uncollected Prescriptions

Cozen O'Connor on

A bipartisan coalition of 50 AGs settled with Walgreens Boots Alliance, Inc. and Walgreen Co. (collectively, “Walgreens”) to resolve allegations that they billed federal and state government health care programs for...more

Rivkin Radler LLP

Provider and Beneficiaries Conspired to Defraud Louisiana’s Medicaid Program

Rivkin Radler LLP on

Healthcare fraud is prevalent within state Medicaid programs due to the massive amounts of money flowing through the system. In Louisiana, the Estate of Yolanda Burnom and her former company, Community Healthcare Solutions,...more

ArentFox Schiff

Investigations Newsletter: Home Health Care Company to Pay $3 Million to Resolve FCA Allegations

ArentFox Schiff on

Home Health Care Company to Pay $3 Million to Resolve FCA Allegations - The US Department of Justice (DOJ) announced that Saad Enterprises Incorporated, operating as Saad Healthcare, agreed to pay $3 million to resolve...more

Troutman Pepper Locke

Vermont AG Clark Secures $2.7M Judgment Against Mental Health Counselor

Troutman Pepper Locke on

On February 4, a Vermont Superior Court judge entered a $2,733,989.47 judgment against Phoenix Counseling & Wellness, PLC (Phoenix), and the company’s owner for alleged violations of the Vermont False Claims Act (VFCA)....more

Quarles & Brady LLP

“It’s Okay, These Products Aren’t Paid for by Medicare” – Think Again

Quarles & Brady LLP on

A recent Securities and Exchange Commission (“SEC”) settlement with DMK Pharmaceuticals Corporation (“DMK Pharmaceuticals”) and its Chief Financial Officer (“CFO”) serves as a good reminder that SEC-regulated entities...more

Morrison & Foerster LLP

DOJ Announces $2.92 Billion in False Claims Act Recoveries in Fiscal Year 2024

Morrison & Foerster LLP on

The Department of Justice published its False Claims Act (FCA) statistics for Fiscal Year 2024 this month, revealing a nearly 40% increase in whistleblower filings, increased recoveries year over year, and a near record...more

Rivkin Radler LLP

FCA Delivers: Government Recovered $2.9 Billion in 2024

Rivkin Radler LLP on

The U.S. Department of Justice (DOJ) recovered $2.9 billion under the False Claims Act (FCA) in 2024, a 5% bump from 2023. This total represents the most recovered since 2021 and reaffirms the FCA’s central role in the...more

Mintz - Health Care Viewpoints

EnforceMintz — Additional Health Care Provider Joins the OIG’s “Heightened Scrutiny” List in 2024

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The HHS Office of Inspector General (OIG), in connection with its enforcement responsibilities, must exclude a party from the federal health care programs if the party is found to have violated certain federal laws. This type...more

Mintz - Health Care Viewpoints

EnforceMintz — Long Tail of Pandemic Fraud Schemes Will Likely Result in Continued Enforcement for Years to Come

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In last year’s edition of EnforceMintz, we predicted that 2024 would bring an increase in False Claims Act (FCA) enforcement activity related to COVID-19 pandemic fraud. Those predictions proved correct. The COVID-19 Fraud...more

Troutman Pepper Locke

AGs Take Action Regarding Medicaid Fraud

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This month, two attorneys general (AGs) have settled False Claims Act investigations with two separate companies in the health care industry. Both settlements were notable in their own right....more

ArentFox Schiff

Investigations Newsletter: Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme

ArentFox Schiff on

Owner, Operator of Texas Lab Charged for $79 Million Medical Testing Fraud Scheme - On November 20, Osman Syed, the owner and operator of a laboratory in Texas, was charged with three counts of health care fraud,...more

Holland & Knight LLP

DOJ Scrutinizes Financial Arrangements of Florida Physician Practice

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The U.S. Department of Justice (DOJ) announced in a Nov. 12, 2024, press release that an ophthalmology practice with offices located in West Central Florida (the Provider) entered into an approximately $1.3 million settlement...more

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