Freedom Health agreed to pay $31.7M to settle allegations of False Claims Act violations relating to Medicare Advantage payment schemes. The settlement underscores regulatory enforcement in managed care and Medicare compliance.
The DOJ sues Inland Empire Health Plan for allegedly misusing $320 million in federal Medicaid surplus funds, highlighting compliance challenges in managed care programs.
A Massachusetts court awarded attorneys' fees to FCA defendants after finding relator engaged in fraudulent conduct by ordering unnecessary PCR tests to support whistleblower claims under the False Claims Act.
2024 report shows skilled nursing improper payments at 17.2%, double Medicare average. Strong compliance and thorough documentation crucial to avoid audits and fraud allegations.
Eye Consultants of Pennsylvania agrees to $790,000 settlement over False Claims Act violations involving Medicare E&M billing irregularities. Federal enforcement underscores commitment to Medicare compliance.
The DOJ and HHS have reestablished the False Claims Act Working Group to heighten enforcement of healthcare fraud, focusing on Medicare, Medicaid, pricing, and EHR compliance risks.
The DOJ and HHS have established a joint False Claims Act Working Group to strengthen healthcare fraud investigations using advanced data analytics and interagency cooperation.
In July 2025, DOJ and HHS formed a joint Working Group to intensify False Claims Act enforcement, focusing on data-driven investigations and payment suspensions in healthcare fraud cases.
The DOJ and HHS reestablish the False Claims Act Working Group to enhance enforcement against healthcare fraud and abuse in federal programs, emphasizing compliance and whistleblower roles.
Detailed analysis of recent Medicare Advantage enforcement activities focused on broker arrangements, Oak Street settlement, and DOJ False Claims Act litigation impacting healthcare compliance and beneficiary protection.
