False Claims Act
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Podiatrist, pharma rep sentenced to 63 months for healthcare fraud
In a case involving an unlicensed person performing medical procedures on unwitting patients, the two California men billed state and federal programs $3.2m in false claims.
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Medicare Advantage risk-coding dispute ends in $117.7m Aetna settlement
Insurer agreed to resolve US allegations that inaccurate diagnosis data for plan members inflated risk-adjusted payments from federal Medicare program.
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FCA Healthcare roundup: Three cases of billing medically unnecessary products and services
Our in-brief, biweekly roundup of notable DOJ False Claims Act cases related to healthcare fraud.
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FCA Healthcare roundup: Two cases of medically unnecessary products and services
Our in-brief, biweekly roundup of notable DOJ False Claims Act cases related to healthcare fraud.
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FCA Healthcare roundup: Three cases of Medicare and Medicaid fraud in IL, MN, NY
Our in-brief, biweekly roundup of notable US Department of Justice False Claims Act cases related to healthcare fraud.
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DOJ files FCA complaint against Louisiana hospital group, three hospitals, physician
The complaint alleges a scheme to provide unnecessary medical care to increase Medicare payouts.
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DOJ secures record-breaking $6.8 billion in False Claims Act settlements, judgments for FY 2025
The healthcare fraud category took the lion’s share with a staggering $5.7 billion in recovered funds from FCA matters.
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DOJ announces $556m settlement with Affiliates of Kaiser Permanente
The settlement resolves allegations that the healthcare consortium was pressuring its physicians to alter medical records to support increased reimbursement rates.