On January 5, 2026, the Office of Inspector General (“OIG”) for the Department of Health and Human Services published Advisory Opinion No. 25-12 (“AO 25-12”), an unfavorable opinion regarding sign-on bonuses offered to...more
1/16/2026
/ Advisory Opinions ,
Anti-Kickback Statute ,
Beneficiary Inducement ,
Caregivers ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Fraud ,
Healthcare Workers ,
Home Health Agencies ,
Medicaid ,
OIG ,
Regulatory Oversight ,
Regulatory Requirements
In an indictment announced on October 26, 2023 in Miami, the U.S. Department of Justice, Criminal Division’s Fraud Section, working with the FBI and HHS-OIG, brought what may be only the second federal criminal charges...more
11/2/2023
/ Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Fee-for-Service ,
Health Insurance ,
Healthcare ,
Healthcare Fraud ,
Indictments ,
Medicare Advantage ,
Medicare Part C ,
Risk Adjustment Formula
On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV)...more