On June 11, 2025, the recently confirmed Assistant Attorney General for the Civil Division, Brett Shumate, issued a memorandum directing Civil Division lawyers to prioritize investigations and enforcement actions advancing...more
On June 2, 2025, the Department of Health and Human Services Office of Inspector General (HHS-OIG) announced the release of its Spring 2025 Semiannual Report to Congress. Covering the period from October 1, 2024, to March 31,...more
6/5/2025
/ Centers for Medicare & Medicaid Services (CMS) ,
Criminal Investigations ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud Abuse and Waste ,
Government Agencies ,
Healthcare Fraud ,
Information Reports ,
Investigations ,
Medicare ,
Medicare Advantage ,
OIG
On May 22, 2025, the Supreme Court unanimously declined to limit federal wire fraud to cases involving economic loss to the victim, upholding convictions of two government contractors who obtained contracts from a state...more
On May 19, 2025, Deputy Attorney General Todd Blanche announced a new Civil Rights Fraud Initiative within the Department of Justice to “utilize the False Claims Act to investigate and, as appropriate, pursue claims against...more
5/21/2025
/ Civil Rights Act ,
Department of Justice (DOJ) ,
Diversity and Inclusion Standards (D&I) ,
Enforcement Priorities ,
Executive Orders ,
False Claims Act (FCA) ,
Federal Funding ,
Students for Fair Admissions v Harvard College ,
Trump Administration ,
Universities ,
Whistleblowers
On March 26, 2025, the U.S. Department of Justice (DOJ) announced that it settled a False Claims Act (FCA) action against a California-based healthcare provider and a separate radiology group for allegedly submitting and...more
On February 21, 2025, the Supreme Court unanimously held that requests for reimbursement from a privately administered fund qualified as “claims” under the False Claims Act (FCA) because the government “provide[d]” a...more
On January 8, 2025, the U.S. Department of Justice (DOJ) announced that a federal grand jury indicted the Chesapeake Regional Medical Center (CRMC) in Virginia for conspiracy to defraud the United States and health care...more
1/30/2025
/ Criminal Conspiracy ,
Criminal Liability ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Hospitals ,
Indictments ,
Medicaid ,
Medicare Advantage ,
Physicians ,
Whistleblowers
On January 21, 2025, President Trump issued an executive order titled “Ending Illegal Discrimination and Restoring Merit-Based Opportunity” (the Order), which seeks to eliminate diversity, equity, and inclusion (DEI) policies...more
1/28/2025
/ Affirmative Action ,
Civil Rights Act ,
Corporate Counsel ,
Department of Labor (DOL) ,
Diversity and Inclusion Standards (D&I) ,
Employment Litigation ,
Executive Orders ,
False Claims Act (FCA) ,
Federal Contractors ,
OFCCP ,
Trump Administration
In a groundbreaking opinion issued on September 30, 2024, Judge Kathryn Kimball Mizelle of the U.S. District Court for the Middle District of Florida dismissed a False Claims Act (FCA) lawsuit, holding that the qui tam...more
In October, the U.S. Department of Justice announced a rare criminal indictment involving the Medicare Advantage program — a contrast from the DOJ's more typical use of its civil enforcement authority to pursue similar issues...more
The U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more
11/17/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Cooperation ,
Criminal Prosecution ,
Declination ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Indictments ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Part C ,
Voluntary Disclosure
On June 1, 2023, the Supreme Court decided a pair of closely watched False Claims Act (FCA) cases, U.S. ex rel. Schutte v. SuperValu Inc., No. 21-1326, and U.S. ex rel. Proctor v. Safeway, Inc., No. 22-111....more
6/5/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Materiality ,
Medicaid ,
Medicare ,
Misrepresentation ,
Objective Falsity ,
Pharmacies ,
Prescription Drugs ,
Safeco Insurance Co of America v Burr ,
Scienter ,
SCOTUS ,
Subjective Standard ,
Universal Health Services Inc v United States ex rel Escobar ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
On January 13, 2023, the Supreme Court granted certiorari in a pair of consolidated cases from the Seventh Circuit that could result in one of the most consequential False Claims Act (FCA) decisions since the FCA was amended...more
On January 25, 2022, in United States ex rel. Sheldon v. Allergan Sales, LLC, a divided panel of the U.S. Court of Appeals for the Fourth Circuit held that a defendant accused of violating the False Claims Act (FCA) by...more