Healthcare fraud
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Texas doctor illegally distributed a million opioid doses through strip mall pill-mill
Physician found guilty of one count of conspiracy to distribute controlled substances and four counts of unlawful distribution.
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DOJ signals assertive enforcement of life sciences sector at PCC
For compliance professionals attending the annual conference, the takeaway was hard to miss: 2026 will require a more rigorous compliance framework and transparency.
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DOJ fraud division launches west coast healthcare fraud ‘strike force’
The new strike force will target healthcare fraud schemes across California, Arizona, and Nevada, bringing expanded federal enforcement to tech hubs and emerging fraud hotspots.
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DOJ program invites data-mining whistleblowers
The new program responds to the growing use of public data to generate often-lucrative whistleblower complaints.
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Health‑related fraud cases feature in latest DOJ enforcement actions
Healthcare-related enforcements totaled nearly $74m in just one week.
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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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FinCEN advisory warns of expanding healthcare fraud, empowers whistleblowers
The advisory urged insiders at financial institutions to be vigilant for fraudsters, organized crime groups, and transnational criminal organizations that increasingly target government benefits programs.
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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.