The last week of June was a busy one when it comes to news about prior authorization – a major tool used by health plans and the federal government to manage healthcare utilization. The week started with a commitment from...more
The U.S. Department of Justice’s ("DOJ") Criminal Division recently issued a memorandum outlining a shift in the DOJ’s priorities and policies for prosecuting white-collar crime (the “Memorandum”). Issued by the Head of the...more
On March 20, 2025, President Trump issued an Executive Order intended to eliminate waste and save taxpayer dollars by consolidating the domestic federal procurement processes within the General Services Administration (GSA)....more
Companies would be wise to take into consideration the potential outsized impact of DOGE as they develop public policy plans for the new administration. DOGE is intended to serve as an advisory or consulting organization...more
Healthcare organizations face an ever-growing list of regulatory demands and risks, with Fraud, Waste, and Abuse (FWA) at the forefront. Addressing FWA is more than avoiding fines under regulations like the False Claims Act –...more
Corporate entities have significant responsibilities in managing and allocating resources effectively. The need to ensure proper use of funds for critical development and construction projects, as well as other large-scale...more
Eleventh Circuit Affirms “Exceptional Case” Ruling: Insurer Had No Duty to Defend Construction Debris Claim Where Amended Complaint Omitted Crucial Fact Implicating Pollution Exclusion The Eleventh Circuit, affirming the...more
The FCC’s National Lifeline Accountability Database (“NLAD”) now is operational in all states and has already had a significant impact in reducing waste, fraud, and abuse. The FCC announced today that, so far, the NLAD has...more
Outlining its high-level priorities and goals for the next five years, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published its Strategic Plan for 2014-2018. In the Strategic...more
The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more