I recently authored a two-part article series published on The Compliance & Ethics Blog highlighting key updates in healthcare fraud compliance and enforcement, including insights from the firm’s annual 2023 Healthcare Fraud & Abuse Review and updates thus far in 2024.

Continue Reading Series on Healthcare Fraud Risk for The Compliance & Ethics Blog

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

Halfway through 2024, the government’s False Claims Act (FCA) enforcement efforts show few signs of letting up.  Last month alone, the Department of Justice (DOJ) announced at least five eight-figure FCA settlements, resolving allegations ranging from unlawful kickbacks to upcoding to improper subcontracting to cybersecurity violations. 

Continue Reading False Claims Act Settlements to Know from Q2 2024

We have previously discussed the California Insurance Frauds Prevention Act (IFPA)–a state antifraud statute that, while modeled on the False Claims Act (FCA), is unique in targeting fraud in the commercial health insurance space.

Continue Reading The California Insurance Frauds Prevention Act: Recent Developments Regarding California’s Powerful Commercial Health Insurance Fraud Statute