The Department of Justice (DOJ) recently announced the largest National Health Care Fraud Takedown in its history, charging 455 defendants—including 90 physicians and other licensed medical professionals—in schemes involving more than $6.5 billion in alleged false claims.

Continue Reading DOJ’s $6.5 Billion National Health Care Fraud Takedown Signals a New Era of Data-Driven Enforcement

It is not every day that an 83-page qui tam complaint alleging Stark Law and Anti-Kickback Statute (AKS) violations is dismissed at the pleading stage, particularly when filed by experienced relator’s counsel and accompanied by more than 30 pages of detailed claims data.  But that was exactly the result in U.S. ex rel. Kyer v. Thomas Health System, a June 4 decision from a unanimous Fourth Circuit panel.

Continue Reading Smoke is Not Fire: Fourth Circuit Rejects Stark and AKS Theories Built on Ordinary Business Practices and Conclusory Allegations

As procurement fraud enforcement continues to be a priority for the Department of Justice and other federal agencies, we take a look back at significant 2025 enforcement developments affecting government contractors, grant recipients and participants in federal programs in our 2025 Procurement Fraud Review.

Continue Reading Procurement Fraud Enforcement Trends Continue Into 2026

Skin substitutes, bioengineered or natural materials designed to promote healing by replacing or supporting damaged skin, have become a key component of advanced wound care. But the significant Medicare reimbursement of these products commanded over the last few years has made them a prime target for enforcement by the Department of Justice and the Department of Health and Human Services Office of Inspector General (OIG).  

Continue Reading Federal Court Seizes $2 Million from Wound Care Clinic: What Providers, Distributors, and Manufacturers Need to Know

I provided insight for Law360 on the government’s recent settlement with IBM to settle allegations into the company’s diversity, equity and inclusion (DEI) practices. The IBM deal is the first of its kind involving a company and alleged violations of the False Claims Act related to DEI practices. The article suggests this deal may signal the Department of Justice’s (DOJ) focus on enforcement actions involving DEI and the potential fines incurred.

Continue Reading Takeaways from IBM’s DEI Settlement

I recently shared my perspective on President Trump’s newest executive order, which is designed to restrict federal contractors from participating in what the administration characterizes as “racially discriminatory” DEI efforts. Under this order, certain DEI‑related activities could put a contractor’s eligibility for future federal work at risk.

Continue Reading Understanding the False Claims Act Implications of Trump’s Latest DEI Order for Federal Contractors

I was quoted in an article published by McKnight’s Long-Term Care News examining the Eleventh Circuit’s pending decision in United States ex rel. Zafirov v. Florida Medical Associates that could determine whether the False Claims Act’s (FCA) whistleblower (qui tam) provisions are constitutional. The decision could potentially limit private individuals’ ability to pursue fraud cases on the government’s behalf and set up a Supreme Court review that could significantly reshape healthcare fraud enforcement nationwide.

Continue Reading Pending Circuit Court Case Concerning the Constitutionality of the FCA’s Whistleblower Provisions

I recently provided insight for a Modern Healthcare article that examines the Department of Justice’s (DOJ) increased healthcare fraud enforcement efforts and growing use of artificial intelligence (AI) and data analytics in civil investigations. While whistleblower complaints continue to account for a substantial share of False Claims Act recoveries, the article highlights how enforcement agencies are increasingly using technology to identify billing outliers and support government-initiated investigations.

Continue Reading DOJ’s Expanding Healthcare Fraud Enforcement Efforts