Trump administration proposes a Medicare and Medicaid pilot to cover GLP-1 weight loss drugs, highlighting access benefits alongside fraud and regulatory oversight challenges.
Krishna Gidwani pleaded guilty to conspiracy in a $4M Medicare fraud involving durable medical equipment. Part of DOJ's 2025 National Health Care Fraud Takedown.
The DOJ is investigating UnitedHealth Group's Medicare billing practices, focusing on diagnostic coding and in-home evaluations that may have led to inflated government payments. This probe highlights compliance and regulatory risks in Medicare Advantage programs.
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 is investigating UnitedHealth Group for Medicare Advantage billing practices amid nationwide scrutiny on upcoding, prompting CMS to increase audits of plans and intensify fraud prevention efforts.
Operation Gold Rush exposes a $10.6 billion Medicare fraud scheme involving international crime rings and highlights the shift towards AI-driven proactive fraud prevention and enhanced Medicare data analytics.
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.
