News & Analysis as of

Settlement False Claims Act (FCA) Hospitals

Harris Beach Murtha PLLC

Scrutiny of Hospital–Physician Relationships Continues

Despite changes in many priorities, the federal government’s scrutiny of relationships between hospitals and physicians continues well into 2025. Last month, Community Health System (CHS) in California and its affiliate,...more

WilmerHale

DOJ Settles False Claims Act Suit Against Medicare Advantage Provider

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On March 26, 2025, the U.S. Department of Justice (DOJ) announced that it settled a False Claims Act (FCA) action against a California-based healthcare provider and a separate radiology group for allegedly submitting and...more

Bass, Berry & Sims PLC

13th Annual Healthcare Fraud & Abuse Review - 2024

Bass, Berry & Sims is pleased to announce the release of the 13th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2024. Compiled by the firm's Healthcare Fraud & Abuse Task Force,...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

Foley Hoag LLP - White Collar Law &...

Hospital Avoids Admissions in False Claims Act Settlement, While Repeat Relator and Government Cash in on Medical Necessity...

There was a noteworthy False Claims Act (FCA) settlement made public yesterday out of the Eastern District of California involving Oroville Hospital. The government accused the Hospital of submitting false claims to Medicare...more

Lathrop GPM

Fighting the Robots: Texas Attorney General Settles “First-of-its-Kind” Investigation of Healthcare AI Company

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In what it describes as a “First-of-its-Kind Healthcare Generative AI Investigation”, the Texas Attorney General (AGO) recently reached a settlement agreement with an artificial intelligence (AI) healthcare technology...more

Robinson+Cole Health Law Diagnosis

South Dakota Hospital Settles False Claims Act Allegations for Over $14 Million Following Self-Disclosure

On September 18, 2024, the Department of Justice (DOJ) announced a settlement with Dunes Surgical Hospital and United Surgical Partners International, Inc. (USPI), an entity holding a partial ownership interest in Dunes, in...more

Lathrop GPM

Now is Not the Time to Relax: Record Settlements in Stark Law and False Claims Cases

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In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - February 2024 #4

News Briefs - State AGs Urge Congress to Reform Pharmacy Benefit Managers - A bipartisan group of 39 state attorneys general sent a letter to Congress urging lawmakers to take "decisive action" to reform pharmacy benefit...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2023

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There have been several noteworthy False Claims Act (FCA) settlements in the second quarter of 2023.  Four of these settlements have come in over $20 million. This post summarizes key settlements of interest....more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | March 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for March 2023. We discuss several criminal and civil enforcement actions that involve Anti-Kickback Statute (AKS) and...more

Bass, Berry & Sims PLC

11th Annual Healthcare Fraud & Abuse Review 2022

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We are pleased to bring you our 11th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more

Gardner Law

Anti-Fraud & Sunshine Update

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Staying up-to-date with fraud enforcement trends and recent cases and settlements can sometimes be viewed as a “Glass Half Empty” perspective, focusing on negative aspects of the industry and the perceived threat of...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q2 2022

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The second quarter of 2022 brought a number of noteworthy False Claims Act (FCA) settlements, including several of $20 million or more. This post summarizes key settlements of interest to healthcare providers....more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 18. News Briefs: May 2022

Report on Medicare Compliance 31 no. 18 (May 16, 2022) - In a new report, the HHS Office of Inspector General (OIG) said 25% of Medicare beneficiaries experienced patient harm (adverse events and temporary harm events)...more

Bass, Berry & Sims PLC

False Claims Act Settlements to Know from Q1 2022

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The first quarter of 2022 brought news of several noteworthy False Claims Act (FCA) settlements, including several settlements by physicians regarding arrangements deemed to be unlawful kickbacks and the first settlement...more

Bass, Berry & Sims PLC

2021 Recap: Hospitals’ Significant False Claims Act Settlements

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Each year, the Department of Justice (DOJ) recovers millions of dollars through False Claims Act (FCA) settlements, and 2021 was no exception. Some of the most sizeable or otherwise noteworthy settlements from 2021 were with...more

Bass, Berry & Sims PLC

The California Insurance Frauds Prevention Act: What to Know About California’s Powerful Commercial Health Insurance Fraud Statute

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Although this blog focuses mainly on the federal False Claims Act (FCA), other antifraud statutes feature in the qui tam relator and government enforcement toolkit. Key among them: the California Insurance Frauds Prevention...more

ArentFox Schiff

Texas Hospital to Pay Over $3 Million to Resolve False Claims Act Allegations

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John Peter Smith Hospital (JPS) agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding hundreds of claims submitted to federal healthcare programs. Texas Hospital to...more

Saul Ewing LLP

Texas Hospital and Co-Defendants to Pay More Than $16 Million to Settle Lawsuits Alleging False Claims Act and Anti-Kickback...

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On September 28, 2020, the U.S. Department of Justice (DOJ) announced that Lakeway Regional Medical Center LLC (LRMC) in Texas agreed to pay $13,580,822.79, and Surgical Development Partners LLC, Surgical Development Partners...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 25. News Briefs: July 2020

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  -  Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 20. News Briefs: June 2020

Report on Medicare Compliance 29, no. 20 (June 1, 2020) - The HHS Office of Inspector General (OIG) has unveiled its “OIG Strategic Plan: Oversight of COVID-19 Response and Recovery.” Its goals are protecting people, funds...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 6. News Briefs: February 2020 #3

Report on Medicare Compliance 29, no. 6 (February 17, 2020) - Tenet Healthcare Corp. and an affiliated hospital, Desert Regional Medical Center, have agreed to pay $1.41 million to settle False Claims Act (FCA)...more

ArentFox Schiff

Investigations Newsletter: Kentucky Hospital Agrees to Pay $10 Million to Resolve False Claims Act Allegations

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Headlines that Matter for Companies and Executives in Regulated Industries - Kentucky Hospital Agrees to Pay $10 Million to Resolve False Claims Act Allegations - Jewish Hospital & St. Mary’s Healthcare Inc. d/b/a...more

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