As described in a previous blog post, the 2026 DOJ Health Care Fraud Takedown reflects an increased enforcement focus on Medicaid. Because Medicaid dollars are both federal and state in origin, a single set of allegations can expose a provider to federal FCA liability, state false claims liability, MFCU investigation, state administrative remedies, and HHS-OIG oversight at once. Three areas in particular have drawn recent enforcement attention.
Continue Reading Medicaid Fraud Enforcement in 2026: High-Risk Areas for Home Care, Behavioral Health and Skilled Nursing ProvidersMedicare/Medicaid
What Happens in Vegas…Gets DOJ’s Attention: $95M Wound Care Fraud Indictment
On August 5, the U.S. Department of Justice (DOJ) announced that a federal grand jury in the District of Nevada returned a six-count indictment charging Stephen Dubin, M.D., of Henderson, Nevada, with conspiracy to commit healthcare fraud and five counts of healthcare fraud. The charges against Dr. Dubin arise from an alleged scheme to defraud Medicare of approximately $95 million through the billing of medically unnecessary amniotic wound allografts to elderly Medicare beneficiaries as well as alleged kickbacks and rebates from two allograft distributors; sham full-price invoices; and, as to one distributor, a pass-through bank account held in the name of a shell company. According to DOJ, Medicare paid over $54 million on the allegedly fraudulent claims.
Continue Reading What Happens in Vegas…Gets DOJ’s Attention: $95M Wound Care Fraud Indictment
Federal Court Seizes $2 Million from Wound Care Clinic: What Providers, Distributors, and Manufacturers Need to Know
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 KnowGenetic Testing Fraud: Why CMS and DOJ Are Increasing Scrutiny
By Danielle Sloane on
In 2025, the Department of Justice’s National Health Care Fraud Takedown led to criminal charges against 324 defendants and $14.6 billion in intended losses.
Continue Reading Genetic Testing Fraud: Why CMS and DOJ Are Increasing ScrutinyHHS-OIG’s Latest Wound Care Report Warrants Careful Scrutiny
On 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 ScrutinyFalse Claims Act Settlements to Know from the First Half of 2025
With 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 2025False 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 ReviewImpact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
By Denise Barnes & Scott Gallisdorfer on
Posted in Civil Investigative Demands, Civil Monetary Penalties, Compliance, Damages, Enforcement, FCA Alert, Government Contracts, Government Knowledge, Healthcare Providers, Hospitals, Knowledge/Scienter, Legislation, Materiality, Medicare/Medicaid, Penalties, Public Disclosure Bar, Retaliation, Whistleblower
As federal contractors and grant recipients navigate the changing landscape of diversity, equity, and inclusion (DEI) programs, the Trump administration’s rescinding of Executive Order No. 11246 (EO) raises new concerns about potential False Claims Act (FCA) liability for non-compliance.
Continue Reading Impact of Trump Administration’s Executive Order on DEI Programs and FCA LiabilityExecutive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
The Trump administration’s recent executive order targeting diversity, equity, and inclusion (DEI) programs is reshaping the landscape for healthcare providers, with potential legal and regulatory implications that are still unfolding.
Continue Reading Executive Order on DEI Programs: Implications for Healthcare and False Claims Act RisksCMS Publishes New Data on Self-Referral Disclosure Protocol Settlements
By Travis Lloyd, Kristin Bohl & Justin Brown on
The Centers for Medicare & Medicaid Services (CMS) recently published updated data regarding settlements made under the Voluntary Self-Referral Disclosure Protocol (SRDP), an important mechanism through which providers may disclose actual or potential violations of the federal physician self-referral prohibition commonly known as the Stark Law.
Continue Reading CMS Publishes New Data on Self-Referral Disclosure Protocol Settlements