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
Settlement
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
Success of Repeat Whistleblower in Recent FCA Settlement
By Matt Curley on
Posted in Settlement, Whistleblower
I commented on the success of serial whistleblower Cecilia Guardiola in her most recent False Claims Lawsuit (FCA) against a healthcare provider. Since 2007 she has secured at least four settlements totaling more than $43 million against healthcare companies; her cut of the settlements is estimated to be about $7.7 million.Continue Reading Success of Repeat Whistleblower in Recent FCA Settlement
DOJ Brings Nationwide False Claims Act Lawsuit Against CVS for Alleged Violations of Controlled Substances Act
By Theresa Androff, Brian Irving & Lisa Rivera on
On December 13, the U.S. Department of Justice (DOJ) intervened in a False Claims Act (FCA) lawsuit alleging that CVS Pharmacy Inc. and its subsidiaries improperly sought federal reimbursement for prescriptions filled in violation of the Controlled Substances Act (CSA).
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Rite Aid and OptumRx Settlements Highlight Enforcement Focus on Pharmacy Corresponding Responsibility for Dispensing Controlled Substances
By Theresa Androff, Brian Irving & Lisa Rivera on
On July 10, the Department of Justice (DOJ) announced a nearly $410 million settlement with Rite Aid Corporation to resolve allegations that Rite Aid and its affiliates ignored red flags and knowingly dispensed unlawful controlled substances in violation of the False Claims Act (FCA) and Controlled Substances Act (CSA). Continue Reading Rite Aid and OptumRx Settlements Highlight Enforcement Focus on Pharmacy Corresponding Responsibility for Dispensing Controlled Substances
Expect More Cyber-Enforcement under the False Claims Act
By Taylor Sample on
Earlier this month, the White House released the National Cybersecurity Strategy Implementation Plan outlining specific “high impact initiatives” that the federal government will carry out to achieve its cybersecurity objectives. Continue Reading Expect More Cyber-Enforcement under the False Claims Act
CMS 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
Recent FCA Settlements in Government Contracts Cases
By Charlotte Elam on
The government continues to prioritize fraud involving government contractors, as the Department of Justice’s (DOJ) most recent annual report on civil fraud recovery shows. Continue Reading Recent FCA Settlements in Government Contracts Cases
DOJ Releases Annual Civil Fraud Recovery Statistics and Results
By John Eason on
On February 7, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for the prior fiscal year, along with its accompanying press release highlighting its civil enforcement efforts. Our top ten observations from DOJ’s release include:Continue Reading DOJ Releases Annual Civil Fraud Recovery Statistics and Results