The 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 Importers
Enforcement
Exploring the DOJ’s Use of AI in Healthcare Fraud Enforcement
By Matt Curley on
Posted in Enforcement, FCA Deep Dive
TIn 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 Enforcement
Wound Care in the Crosshairs: Reimbursements Risks Amid Skin Substitute Fraud Investigations
By Kristin Bohl, Denise Barnes & Garrah Carter-Mason on
Effective 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
Healthcare Fraud Enforcement Trends from 2024 and Projected Issues for 2025
By Taylor Sample on
I recently authored an article for the American Bar Association (ABA) Health Law Section regarding healthcare fraud enforcement trends in 2024 and the projected issues for 2025, which highlights the Department of Justice’s (DOJ) increasing focus on fraud, waste, and abuse.Continue Reading Healthcare Fraud Enforcement Trends from 2024 and Projected Issues for 2025
Planned Use of FCA to Enforce Civil Rights Fraud Initiative in Higher Education
By Audrey Anderson on
I recently discussed the Trump administration’s plan to apply the False Claims Act (FCA) to enforce its Civil Rights Fraud Initiative, targeting diversity programs. Continue Reading Planned Use of FCA to Enforce Civil Rights Fraud Initiative in Higher Education
DOJ’s Latest False Claims Act Customs Fraud Intervention
By Denise Barnes, Lindsey Fetzer & Thad McBride on
Posted in Enforcement, FCA Alert
We authored an article for Law360 outlining a recent Department of Justice (DOJ) intervention in a False Claims Act (FCA) customs fraud matter. Continue Reading DOJ’s Latest False Claims Act Customs Fraud Intervention
Potential Shift in Healthcare Fraud Oversight
By Brian Roark on
Posted in Enforcement, Hospitals
I recently provided insight about the potential shift in healthcare fraud oversight amid federal changes and several recent cases that could narrow the scope of investigations and ultimately lower costs that health systems spend to fight fraud allegations.Continue Reading Potential Shift in Healthcare Fraud Oversight
DOJ Settlement Highlights Customs, FCA Risks for Importers
On March 25, 2025, the U.S. Department of Justice (DOJ) announced an $8.1 million settlement in a civil case under the False Claims Act (FCA) related to alleged customs evasion by a California importer of wood flooring. The private whistleblower who reported the conduct received over $1.2 million in the matter. As we suggested in…
Seoul Medical Group and Renaissance Imaging Medical Associates Settle Medicare Risk Adjustment Fraud Case for $62 Million
The Department of Justice announced this week that California-based primary care provider Seoul Medical Group, Inc. (SMG), SMG’s former president and majority owner, and California-based radiology group Renaissance Imaging Medical Associates Inc. (Renaissance) will pay a combined $62.85 million to resolve allegations of False Claims Act violations related to the submission of unsupported diagnosis codes to Medicare Advantage Organizations in order to increase reimbursement from the government.Continue Reading Seoul Medical Group and Renaissance Imaging Medical Associates Settle Medicare Risk Adjustment Fraud Case for $62 Million
False Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse Review
The False Claims Act (FCA) remains one of the government’s most powerful tools in combating healthcare fraud, with a growing focus on opioid-related cases and violations of the Anti-Kickback Statute. Continue Reading False Claims Act Enforcement in Healthcare: Insights from the 13th Annual Fraud & Abuse Review