DOJ Sues California Medicaid Plan Over $320M Misused Federal Funds
The DOJ sues Inland Empire Health Plan for allegedly misusing $320 million in federal Medicaid surplus funds, highlighting compliance challenges in managed care programs.
Key Priorities for Enforcing the False Claims Act at the Qui Tam Conference
Explore the DOJ's priorities on the False Claims Act and its implications for healthcare and compliance practices at the Qui Tam Conference.
Changes in False Claims Act Enforcement: Impact on Insurance and Healthcare
Explore the implications of False Claims Act changes for insurance and healthcare. Stay informed on compliance, fraud prevention, and legal strategies.
LaFontaine Management Settles $1.5M PPP Loan Eligibility Dispute
LaFontaine Management agrees to $1.5 million settlement over PPP loan eligibility, emphasizing evolving federal guidelines and compliance in pandemic relief enforcement.
First Circuit Affirms Labs Can Rely on Doctor Orders to Establish Medical Necessity for Medicare Tests
The First Circuit rules that clinical labs can rely on doctors' orders to demonstrate medical necessity under Medicare, impacting FCA fraud claims and regulatory compliance.
Arnold & Porter Lawyers Named Top Legal Experts in Healthcare and Corporate Litigation
Arnold & Porter's Brian Dunphy and Giselle Joffre earn recognition in Boston Magazine's 2025 Top Lawyers list for their expertise in healthcare and corporate litigation, including government investigations and regulatory compliance.
Mindpath Care Centers Settles $1.9M Medicare False Claims Allegation
Mindpath Care Centers settles $1.9 million Medicare false claims case involving behavioral health psychotherapy billing violations. Impact on compliance and regulatory enforcement.
Health First Urgent Care Settles $2.8M Medicare Medicaid Overbilling Case
Health First Urgent Care agrees to $2.8 million settlement for Medicare and Medicaid overbilling linked to improper diagnostic test billing practices in Washington State.
Court Awards Attorney Fees to FCA Defendants Due to Relator's Fraudulent Conduct
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.
Skilled Nursing Improper Payments Double Medicare Average; Compliance Vital
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.