Dear reader,
Recently, on the healthcare front, merger and acquisitions due diligence, healthcare fraud, and state-based initiatives in the public health sphere all took center stage.
Experts estimate that fraud costs taxpayers up to $125 billion annually and a conservative range of 3% to 10% of total healthcare expenditure is lost to fraud and abuse.
The Department of Justice (DOJ) reported $1.257 billion in healthcare fraud false claims settlements between January and May 2025. (See Grip Health Issue 1 for an article covering the DOJ’s 2025 National Healthcare Fraud Takedown)
The Trump administration has made clear that it is committed to using the False Claims Act (FCA) to prosecute healthcare fraud. Two Trump administration moves earlier this year offer insight into what that will look like for industry participants. First, the administration announced the creation of a new interagency False Claims Act Working Group and then announced a National Health Care Fraud Takedown, charging 324 defendants with allegations of over $14.6 billion of healthcare fraud.
The DOJ further announced the creation of the Health Care Fraud Data Fusion Center, saying it will combine experts from the DOJ, Health and Human Service (HHS), and HHS’s Office of the Inspector General to leverage cloud computing, artificial intelligence, and advanced analytics to detect healthcare fraud.
This issue of our magazine explores these items and more. Please read it over an autumnal mug of something warm.
Sincerely yours,
Julie DiMauro
US Content Manager
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California law limits private equity influence on healthcare businesses
California has enacted tougher rules preventing corporate investors like PE firms from meddling in the healthcare decisions of provider firms.
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Podcast: Vaccines – navigating legal challenges and public health policy
Dorit Reiss and Richard Hughes focus on how political interference, shifting vaccine approvals, and regulatory rollbacks are reshaping vaccine policy and public confidence.
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FTC warns healthcare employers on noncompetes
The Federal Trade Commission sent formal letters to major healthcare employers and staffing firms urging them to review restrictive employment agreements.
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NYDFS fines dental plan firm $2m in phishing breach
Failure to use MFA to protect data of 90,000 customers leads to fine and raises legal questions.
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HHS secures $175,000 HIPAA settlement over phishing ransomware breach
The case underscores HHS’s growing focus on business associates and the Risk Analysis Enforcement Initiative.
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HHS FAQs clarify health information disclosure rules
New detail confirms that patient information under HIPAA can be shared by health providers and also reaffirms broad data access rights by patients.
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Over 5.4 million US patient records compromised in Episource data breach
Attack could be a wake-up call for healthcare cybersecurity.