All Healthcare articles
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ArticleNursing home chain and former CEO pay $146M each for federal health fraud
A New Jersey and Midwest nursing home chain, and its former chief executive, must pay more than $146 million each for extensive health care fraud for engaging in widespread fraud related to Medicare and Medicaid.
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ArticleHorizon Blue Cross Blue Shield pays $100M to settle state false claims allegations
Horizon Blue Cross Blue Shield of New Jersey has agreed to pay $100 million to settle allegations that its 2020 contract with the state was fraudulent, according the state’s Attorney General.
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ArticleDOJ is ramping up, not ramping down, health care fraud enforcement
While the Trump administration may have shifted away from pursuing small, white-collar, financial crimes, its focus on health care fraud cases is as hot as ever.
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News BriefHospitals, health IT face HHS crackdown for blocking electronic records
The Department of Health and Human Services is stepping up its enforcement against hospitals and other health entities that block the sharing of electronic health records.
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ArticleJudge orders CVS to pay nearly $290M for Medicare false claims
CVS’s Caremark division knowingly overcharged Medicare for prescription drugs and must pay nearly $290 million, a Pennsylvania federal judge has ordered.
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ArticleFTC secures $145 Million in settlements over misleading health insurance sales and data practices
Two major health insurance brokers will pay a combined $145 million to resolve Federal Trade Commission allegations that they misled millions of consumers and mishandled personal data, the agency announced Thursday.
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ArticleDOJ, SEC end Investigations of GE HealthCare for possible FCPA violations in China
The Securities and Exchange Commission and Department of Justice ended a seven-year review of GE HealthCare Technologies’ China unit for possible violations of the Foreign Corrupt Practices Act.
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ArticleNew York lab CEO allegedly billed insurers for $500M in fraudulent COVID test claims
The U.S. Department of Justice says the chief executive and medical director of Fast Lab Technologies allegedly engaged in a $500 million fraud scheme involving COVID-19 tests.
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PremiumU.K. data law tightens compliance rules, expands complaints process and raises penalties
The U.K.’s Data (Use and Access) Bill, passed into law on June 19, aims to boost the economy and simplify access to services like healthcare and policing. Businesses must understand the changes and ensure data policies and complaints procedures are current.
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News BriefFTC fines telehealth firm over deceptive weight-loss claims and fake reviews
The U.S. Federal Trade Commission said it has settled with telemedicine service Southern Health Solutions, Inc. over allegations the company used deceptive pricing and weight-loss claims, along with fake reviews and testimonials, to sell its weight-loss programs.
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News BriefCVS hit with nearly $1 billion fine in Omnicare false claims verdict
CVS has vowed to appeal $948.8 million in fines and damages imposed by a judge Tuesday on its Omnicare unit, for billing Medicare for tens of thousands of false claims.
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News BriefDOJ targets $14.6B in health care fraud with focus on transnational crime
Emerging enforcement priorities of the U.S. Department of Justice’s health care fraud division align with the Trump administration’s emphasis on prosecuting transnational criminal organizations and ending opioid trafficking.
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News BriefUnitedHealth reportedly investigated for Medicare fraud following CEO departure
UnitedHealth Group is being investigated by the Department of Justice for possible Medicare fraud, according to a report from the Wall Street Journal. The move, which has not so far been announced publicly, follows the sudden departure of its CEO.
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News BriefFTC case against insulin price gouging halted after commissioners fired by Trump
A Federal Trade Commission case against insulin price gouging has come to a screeching halt after two Democratic commissioners were fired by President Donald Trump.
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PremiumNavigating compliance: A guide for small teams to tackle CMMC
Many small organizations within the Defense Industrial Base are struggling to meet the rigorous requirements validated through the Cybersecurity Maturity Model Certification, writes Thomas Graham, CISO at Redspin. If you haven’t been tracking it closely, CMMC was finalized in October, with an effective date of December 16, 2024.
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PremiumMaking a pitch for compliance: The great chase for stakeholder engagement
Speakers at Compliance Week’s Ethics and Compliance Summit swapped engagement strategies rooted in human behavior, including with through the use of generative AI, free merchandise, and live events, to meet employees where they are.
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News BriefDOD health contractors rack up more than $100M in excess payments, DOJ alleges
Six health centers that contracted with the Department of Defense, intentionally overbilled the government for more than $100 million, the Department of Justice alleged in announcing a settlement with one of the plans.
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News BriefSenate votes along party lines to confirm RFK Jr. as secretary of HHS
The U.S. Senate has approved Robert F. Kennedy, Jr. to lead the Department of Health and Human Services, placing President Donald Trump’s controversial pick at the helm of a $1.7 trillion department in transition.
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News BriefArizona couple pleads guilty in vast $1.2B skin graft false claims case
Two owner-operators of three Arizona medical companies have pleaded guilty to billing more than $1.2 billion in false and fraudulent claims to Medicare and other government health programs in less than two years, the Department of Justice said.
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News BriefEx-nursing home operator who defrauded Medicaid sentenced to 12 years in prision
The former operator of a Massachusetts homecare agency was sentenced to 12 years in prison for defrauding Medicaid of more than $100 million, the Department of Justice said.