Daily Compliance News: May 16, 2025, The Ethics Nightmare Edition
Medical Device Legal News with Sam Bernstein: Episode 4
The Centers for Medicare & Medicaid Services (CMS) announced a nationwide six-month enrollment moratoria on new hospice and home health agency (HHA) enrollments in the Medicare program. The moratoria, which takes effect...more
Adam Brosius, a former pharmacy executive, was recently sentenced to 24 months in prison and ordered to pay $33 million in restitution and $27 million in forfeiture. Brosius was the director and then the president of...more
On April 30, 2026, the Department of Justice’s (“DOJ”) National Fraud Enforcement Division (“Fraud Division”) announced the formation of the West Coast Health Care Fraud Strike Force, a multi-district enforcement initiative...more
On April 30, 2026, the Department of Justice’s National Fraud Enforcement Division announced the creation of the West Coast Health Care Fraud Strike Force. This announcement is not just another incremental enforcement...more
On April 21, 2026, in a “Hearing on Protecting Patients and Taxpayers: Cracking down on Medicare Fraud,” the House Ways & Means Committee received testimony on hospice and home health fraud from Sheila Clark, President and...more
After three appearances at congressional committees last week, US Department of Health and Human Services (HHS) Secretary Kennedy will testify in front of four additional committees this week....more
The National Fraud Enforcement Division centralizes existing DOJ fraud resources under a single leadership structure, with plans to rapidly expand prosecutorial capacity nationwide....more
Over the last several years, federal concern about genetic testing has been steadily growing. Regulators have watched Medicare Part B spending on molecular and genetic tests spike while a relatively small number of...more
The McGuireWoods Women’s Health Newsletter delivers information on the latest legal and regulatory developments affecting the women’s health industry. The publication provides timely analysis of legislative changes,...more
The Centers for Medicare and Medicaid Services (“CMS”) recently announced new healthcare fraud measures that include the imposition of a six-month moratorium on provider enrollments of new durable medical equipment,...more
The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) to solicit stakeholder feedback regarding regulatory changes impacting fraud, waste, and abuse in the healthcare industry as part of...more
On February 25, 2026, the Centers for Medicare & Medicaid Services (“CMS”) announced several program integrity actions impacting Medicaid funding and Medicare supplier enrollment, along with a request for stakeholder input...more
The Centers for Medicare & Medicaid Services (CMS) issued a Federal Register notice imposing a six-month nationwide moratorium on new Medicare enrollments for seven types of Durable Medical Equipment, Prosthetics, Orthotics,...more
The US Department of Health and Human Services Office of Inspector General (OIG) released its new Industry Compliance Program Guidance (ICPG) on February 3, 2026. The ICPG is a comprehensive voluntary guidance for entities...more
Last month, Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (“CMS”), accompanied by other CMS officials, visited with home health and hospice providers and related industry associations to discuss...more
Healthcare workers, billing specialists, and medical professionals frequently encounter fraudulent practices that drain billions of dollars from Medicare programs annually. Yet many individuals who witness these schemes...more
On January 21, 2026, OIG released the Fall 2025 Semiannual Report to Congress, summarizing its activities between April 1, 2025, and September 30, 2025....more
Healthcare fraud continues to plague providers, managed care, and drug companies. $5.7 billion of the $6.8 billion recovered by DOJ was generated from the healthcare industry. There is a bottomless pit of possible targets....more
Key Takeaways Background The White House has announced the creation of a new senior enforcement role focused on identifying, coordinating and advancing large-scale fraud matters across federal programs and the private sector,...more
Addressing an issue of first impression, the First Circuit has clarified the burden to satisfy the knowledge element required in False Claims Act (FCA) cases in the context of laboratory testing and Medicare fraud....more
On January 14, the Department of Justice (DOJ) announced that five Kaiser Permanente affiliates agreed to pay $556 million to resolve allegations that they violated the False Claims Act (FCA) by submitting unsupported...more
Takeaway: Wound care fraud is now one of the key enforcement priorities of the Department of Justice. An aging population, combined with Medicare’s pricing policies, nurtured an opportunity for Amniotic Allograft Fraud to...more
A New York physician was recently sentenced in federal court for receiving kickbacks in exchange for ordering medically unnecessary brain scans. Vishnudat Seodat of Mattituck had practiced for 36 years and operated three “New...more
The U.S. Department of Justice recently announced a settlement with Patients Choice Laboratories (“PCL”), a diagnostic laboratory headquartered in Indianapolis, Indiana, under which PCL will pay over $9.6 million to resolve...more
The 2025 National Health Care Fraud Takedown, announced in June, was the largest in history, with 325 defendants charged (including 96 providers) in 50 federal districts. In all, the charged schemes involved more than $14...more