Bass, Berry & Sims will release its 14th Annual Healthcare Fraud & Abuse Review in mid-February. As a companion to the Review, we will host a complimentary webinar on Tuesday, February 24 from 11:00 a.m. – 1:00 p.m. CT, which will provide an overview and discussion of key focus areas covered in the Review.
Continue Reading Register Now | Healthcare Fraud & Abuse Annual Review WebinarOn January 16, the U.S. Department of Justice (DOJ) released its annual report on civil fraud recoveries (settlements and judgments) for FY2025, along with a press release highlighting DOJ’s civil enforcement efforts.
Continue Reading DOJ Releases Record-Setting Civil Fraud Recovery Statistics and Results…Our Annual Look Behind the NumbersOn 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 diagnosis codes for Medicare Advantage (MA) beneficiaries to increase reimbursement from the federal government. The relators will receive approximately $95 million as their share of the recovery.
Continue Reading Kaiser Permanente Affiliates Settle Medicare Risk Adjustment Fraud Case for $556 MillionOn September 9, the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) released a major report (Report) regarding the fraud risks currently associated with skin substitute products billed to Medicare.
Continue Reading HHS-OIG’s Latest Wound Care Report Warrants Careful ScrutinyThe federal government’s growing use of the False Claims Act (FCA) to pursue customs fraud signals a new era of trade enforcement, with importers facing heightened scrutiny and increased risk of whistleblower actions.
Continue Reading Cracking Down on Customs Fraud: How the False Claims Act Raises the Stakes for ImportersWe were quoted in a Law360 article summarizing a September 2025 decision by a Utah federal court to dismiss False Claims Act (FCA) allegations against our clients.
Continue Reading Rare (c)(2)(A) Dismissal of Long-Running FCA CaseWith the first half of 2025 in the rearview mirror, the government’s continued focus on False Claims Act (FCA) enforcement shows no signs of slowing. In fact, the Department of Justice recently announced the results of a record-setting National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants for alleged healthcare fraud schemes involving over $14.6 billion.
Continue Reading False Claims Act Settlements to Know from the First Half of 2025I commented on a recent Ninth Circuit ruling clarifying a 2018 law that prohibits kickbacks for referring patients to medical testing labs and addiction treatment centers under the Eliminating Kickbacks in Recovery Act (EKRA).
Continue Reading Ninth Circuit Ruling Outlining Kickback Limits Under EKRATIn one of its largest coordinated enforcement efforts to date, the Department of Justice recently announced charges against more than 300 defendants in connection with alleged healthcare fraud schemes.
Continue Reading Exploring the DOJ’s Use of AI in Healthcare Fraud EnforcementEffective wound care is critical for patients recovering from surgery or managing chronic or non-healing wounds. Advances in treatment have led to the development of skin substitutes—bioengineered or natural materials designed to promote healing by replacing or supporting damaged skin. While these innovations hold great promise for the future of wound care, they have also come under increased scrutiny by regulatory agencies and the Department of Justice (DOJ).
Continue Reading Wound Care in the Crosshairs: Reimbursements Risks Amid Skin Substitute Fraud Investigations