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.
The DOJ and federal agencies announced the largest healthcare fraud crackdown in U.S. history, charging 324 defendants for $14.6 billion in false Medicare and Medicaid claims, signaling increased enforcement on healthcare compliance.
Michigan woman charged with Medicaid fraud through false mileage reimbursement claims. Case highlights state efforts to combat healthcare fraud and protect Medicaid integrity.
The DOJ arrested two West Covina women for a $4.8 million Medicare fraud scheme involving false hospice care claims. This case underscores challenges in hospice billing and Medicare oversight.
U.S. government files False Claims Act complaint against medical billing company for submitting false Medicare claims related to unnecessary genetic tests.
