Healthcare fraud

Bank Secrecy Act data points to about $17.5 billion in suspicious activity potentially tied to healthcare fraud.

Daniel Ahn is a partner at Reed Smith in the White Collar and Government Investigations Group.

The agency says machine-learning and AI analytics contributed to increased enforcement.

The US DOJ memo outlines fraud enforcement priorities, spotlighting healthcare, tax, trade, and corporate misconduct.

Centers for Medicare & Medicaid Services moves to strengthen oversight of Applied Behavior Analysis services and reduce fraud, waste, and abuse.

The defendants employed scores of call center employees and remote-billers to steal hundreds of millions of dollars from American businesses and launder the stolen monies overseas.

Physician found guilty of one count of conspiracy to distribute controlled substances and four counts of unlawful distribution.

For compliance professionals attending the annual conference, the takeaway was hard to miss: 2026 will require a more rigorous compliance framework and transparency.