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

On May 19, the Department of Justice (DOJ) announced the launch of the Civil Rights Fraud Initiative, which will use the federal False Claims Act (FCA) to pursue claims against recipients of federal funds that knowingly violate federal civil rights law. 

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On April 14, U.S. District Judge Matthew F. Kennelly ruled, in relevant part, that the U.S. Department of Labor (DOL) cannot require federal grant recipients to certify that their diversity, equity and inclusion (DEI) programs do not violate applicable federal anti-discrimination law and prohibited the termination of the plaintiff’s Women in Apprenticeship and Nontraditional

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

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

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

Our 13th annual Healthcare Fraud & Abuse Review, compiled by the Bass, Berry & Sims Healthcare Fraud & Abuse Task Force, is now available, providing an in-depth look at the key enforcement trends, legal decisions, and settlements shaping the healthcare industry in 2024.Continue Reading Download Now – 13th Annual Healthcare Fraud & Abuse Review

In Wisconsin Bell, Inc. v. United States ex rel. Heath, the Supreme Court clarified the definition of “claim” under the FCA. The case resolves a split between the Fifth and Seventh Circuits on whether a request for reimbursement under the E-Rate subsidies program meets the statutory definition of a “claim.”Continue Reading Supreme Court Clarifies “Claim” Definition Under False Claims Act