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CareCore National LLC, a healthcare utilization management company, agreed earlier this month to pay $54 million to settle allegations that it allowed its insurance company customers to inappropriately bill the Medicare and Medicaid programs.

The four DME MAC medical directors have issued a joint open letter to physicians warning about "various marketing schemes" perpetrated by DME suppliers.

The Department of HHS has just announced annual inflation-related increases to CMPs in its regulations, including those promulgated by the Office of Inspector General, the Centers for Medicare & Medicaid Services...

Joon H. Kim, the Acting U.S. Attorney for the Southern District of New York, reported that a doctor and four executives pleaded guilty to a $30 million scheme to defraud Medicare and Medicaid.

In United States ex rel. Barrick v. Parker-Migliorini Int'l, LLC, 878 F. 3d 1224 (10th Cir. 2017), the court affirmed dismissal of the qui tam relator's lawsuit against his former employer ...

Medicaid Fraud Control Units recovered nearly $2 billion in fiscal year 2025, marking record-level criminal recoveries and a 37% increase in civil settlements.

The OIG has released its Medicaid Fraud Control Units Fiscal Year 2013 Annual Report, which highlights achievements from the investigations and prosecutions conducted by the 50 MFCUs along with related OIG oversight activities.

In S.B. v. Tenet Healthcare Corp., No. 17-141-2, 2018 WL 1836029 (11th Cir. April 18, 2018) (per curiam), the Eleventh Circuit affirmed dismissal of S.B.'s complaint for fraud, negligent misrepresentation ...

McGuireWoods partner and host invites Government Investigations & White Collar Litigation partners and to discuss compliance and regulatory challenges...

The court's one-page order did not explain the reasoning for declining the petition, although it noted that the dissenting judge voted in favor of re-hearing.

Crowell & Moring attorneys Jason Crawford, Agustin Orozco, and Jeff McSorely explore the Health Care False Claims Act Self-Disclosure Pilot Program, a groundbreaking initiative that enables healthcare providers, suppliers, manufacturers, and payors to voluntarily report potential civil FCA violations. The discussion examines how this program works and what it means for healthcare entities seeking to proactively address compliance issues.

On November 14, 2007, the Social Security Administration (SSA) confirmed that it would not be issuing "no-match" letters to employers based on information it obtained from employers in 2006.

Last week, we discussed the memorandum released by the Department of Justice emphasizing the Government's commitment to holding individuals accountable when dealing with corporate wrongdoing.

The Yates Memo has many landscape-changing implications for corporate investigations, including the need for enhanced Upjohn warnings and the potential suppression of joint-defense agreements...

The United States District Court for the Western District of Texas, applying Texas law, has held that a cyber policy limited coverage to a single $250,000 sublimit for all cyber crime loss during the policy period, regardless of the amount of loss or number of electronic transfers that gave rise to the loss.

In Great Concepts, LLC v. Chutter, Inc., No. 22-1212 (Fed. Cir. Oct. 18, 2023), the Federal Circuit reversed the Trademark Trial and Appeal Board's ("Board")...

On September 27, 2016, the G20 published its Anti-Corruption Action Plan for 2017-2018 and called on countries to implement the United Nations Convention against Corruption.

In the second of a two-part series on federal investigations within the Department of Homeland Security, host Derrick Kyle continues his discussion with former DHS Deputy Chief Counsel Rob Dunikoski.