News & Analysis as of

Medicare Fraud Whistleblowers

Williams Mullen

U.S. Justice Department Renews Enforcement Focus on Health Care Fraud

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In recent weeks, the Justice Department has issued new charging guidelines and announced enforcement actions that reflect the priorities of the current administration. Targeting perceived health care fraud, particularly...more

Morrison & Foerster LLP

DOJ and HHS Announce Formation of False Claims Act Working Group and Results of National Health Care Fraud Takedown

As we reported in our recent client alert, the Trump administration has made clear that it is committed to using the False Claims Act (FCA) to prosecute healthcare fraud. Two recent Trump administration moves give important...more

Kilpatrick

Healthcare Fraud in the False Claims Act Enforcement Crosshairs: Why Now is the Time to Strengthen Compliance Efforts

Kilpatrick on

The U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services (HHS) have announced that they are revitalizing the DOJ-HHS False Claims Act Working Group. The primary focus of the working group will be...more

Rivkin Radler LLP

DOJ and HHS Announce FCA Working Group

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On July 2, the U.S. Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the formation of the DOJ-HHS False Claims Act Working Group to strengthen “their ongoing collaboration to advance...more

Womble Bond Dickinson

2025 National Health Care Fraud Takedown Sets Record as Largest in U.S. History, Charging 324 Defendants for Over $14.6 Billion in...

Womble Bond Dickinson on

On June 30, 2025, the Department of Justice announced the results of its 2025 National Health Care Fraud Takedown (“2025 Takedown”). ...more

ArentFox Schiff

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

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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

Sheppard Mullin Richter & Hampton LLP

SuperValu Wins False Claims Act Case with a “No Harm, No Foul” Jury Verdict

On March 5, 2025, SuperValu, Inc. (SuperValu), a grocery store chain that operates in-store pharmacies, was cleared of liability by a Central District of Illinois federal jury—finally quashing whistleblower claims that the...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

Arnall Golden Gregory LLP

Narrowing FCA Cases Based on Kickback Allegations: What Healthcare and Life Sciences Companies Need to Know About the Regeneron...

On February 18, 2025, in a closely watched decision, the United States Court of Appeals for the First Circuit in United States v. Regeneron Pharmaceuticals Inc., No. 23-2086, 2025 U.S. App. LEXIS 3667 (1st Cir. Feb. 18, 2025)...more

Bass, Berry & Sims PLC

Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment Requirement

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On February 3, the U.S. Court of Appeals for the Fourth Circuit reversed a district court’s grant of a motion to dismiss, holding in relevant part that: - Violations of a Corporate Integrity Agreement (CIA) can create an...more

Bradley Arant Boult Cummings LLP

The False Claims Act in 2024: A Year in Review

In 2024, the government and whistleblowers were party to 558 False Claims Act (FCA) settlements and judgments, just slightly fewer cases than last year’s record. As a result, collections under the FCA exceeded $2.9 billion,...more

Bradley Arant Boult Cummings LLP

False Claims Act: 2024 Year in Review

Bradley’s Government Enforcement and Investigations Practice Group is pleased to present the False Claims Act: 2024 Year in Review, our annual review of significant False Claims Act (FCA) cases, developments and trends. ...more

K&L Gates LLP

US Department of Justice Announces US$2.9 Billion in Fiscal Year 2024 False Claims Act Recoveries

K&L Gates LLP on

On 15 January 2025, the US Department of Justice (DOJ) published its report (Report) announcing civil recoveries under the False Claims Act (FCA) for Fiscal Year (FY) 2024. The recoveries for FY 2024 exceeded US$2.9 billion,...more

Bradley Arant Boult Cummings LLP

2024 False Claims Act Statistics Show More Cases Filed Than Ever Before

The Justice Department released its annual False Claims Act statistics on Wednesday, January 15, detailing the number of cases filed, recoveries made, and relators’ shares awarded in fiscal year 2024. The government recovered...more

Rivkin Radler LLP

FCA Delivers: Government Recovered $2.9 Billion in 2024

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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

Wiley Rein LLP

DOJ Announces Larger FCA Recoveries and More Whistleblower Cases Filed in 2024

Wiley Rein LLP on

On January 15, 2025, the U.S. Department of Justice (DOJ) announced $2.9 billion in total False Claims Act (FCA) recoveries for FY 2024, a slight increase from 2023. In addition to growing recoveries, DOJ announced a new...more

ArentFox Schiff

Investigations Newsletter: DOJ Reports Nearly $3 Billion in FCA Settlements, Judgments for FY 2024

ArentFox Schiff on

DOJ Reports Nearly $3 Billion in FCA Settlements, Judgments for FY 2024 - On January 15, the US Department of Justice (DOJ) reported that settlements and judgments under the False Claims Act (FCA) totaled more than $2.9...more

Mintz - Health Care Viewpoints

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

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

ArentFox Schiff

Investigations Newsletter: Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions

ArentFox Schiff on

Federal Government Urges Court of Appeals to Uphold Constitutionality of FCA Qui Tam Provisions - In a brief filed earlier this week, the US federal government has urged the Eleventh Circuit Court of Appeals to uphold the...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Second Circuit Expands Anti-Kickback Statute Liability: “At Least One Purpose” is Enough

In a significant ruling, the Second Circuit Court of Appeals recently expanded the scope of the Anti-Kickback Statute (AKS).The Court joined other circuit courts across the country in adopting, for the first time, the...more

McAfee & Taft

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

McAfee & Taft on

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

PilieroMazza PLLC

Florida Federal Court Strikes Major Blow to FCA Whistleblowers: Key Takeaways for FCA Defendants

PilieroMazza PLLC on

In a prior blog, PilieroMazza discussed the Supreme Court’s decision in United States ex rel. Polansky v. Executive Health Resources, Inc. In that case, in his dissenting opinion, Justice Clarence Thomas referred to the qui...more

ArentFox Schiff

Investigations Newsletter: Precision Lens Pays $12 Million to Resolve FCA and AKS Violations

ArentFox Schiff on

Precision Lens Pays $12 Million to Resolve FCA and AKS Violations - Late last week, Precision Lens and the estate of its former principal agreed to pay $12 million to resolve allegations regarding violations of the False...more

Arnall Golden Gregory LLP

Government Investigations Team Insights - July 2024

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more

Arnall Golden Gregory LLP

Wave of the Future: Are AI and Data Mining the Next Generation of “Professional Whistleblowers”?

In the realm of False Claims Act (“FCA”) litigation, the emergence of artificial intelligence (“AI”) and data mining technologies has introduced both opportunities and complexities for defense strategies. Historically, qui...more

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