On May 12, 2025, the U.S. Department of Justice’s Criminal Division released a policy memorandum outlining its enforcement priorities for the upcoming year. The top priority for the division will be investigating and prosecuting white collar crimes related to waste,
The FCA Insider
Insights and updates on False Claims Act Litigation
DOJ Announces Initiative to Use False Claims Act to Investigate DEI Practices
On May 19, 2025, the U.S. Department of Justice announced its new Civil Rights Fraud Initiative, which aims to use the False Claims Act (FCA) to investigate and pursue claims against entities that tolerate antisemitism, allow men to enter women’s…
DOJ Targets Neurofeedback Billing in $15 Million Behavioral Health Fraud Case
On March 6, 2025, federal prosecutors charged a Minnesota couple with orchestrating a $15 million healthcare fraud scheme involving overbilling and submission of false claims for neurofeedback and other behavioral health services performed by a network of behavioral health clinics.…
Fifth Circuit Concurrence Adds Voice to FCA Constitutionality Questions
First Circuit Adopts “But For” AKS Standard, Leaving Third Circuit Alone in Causal-Link Standard
CMS Nearly Doubles Prior Stark Self-Disclosure Dollar Record in 2024
The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2024 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law (the Stark Law). In 2024, CMS settled an agency record…
Fourth Circuit Upholds OIG Advisory Opinion Process
On January 23, 2025, the United States Court of Appeals for the Fourth Circuit rejected a challenge to Advisory Opinion 22-19 (the “Advisory Opinion”) issued by the United States Department of Health and Human Services, Office of Inspector General (“OIG”).…
Department of Justice Suggests “Aggressive” Enforcement of False Claims Act
On February 20, 2025, during a speech to the Federal Bar Association’s annual qui tam conference, Michael Granston, Deputy Assistant Attorney General for the Commercial Litigation Branch at the U.S. Department of Justice (DOJ), said that the Trump Administration will…
D.C. Circuit Prohibits Pro Se Plaintiffs from Bringing FCA Cases
Second Circuit Joins Other Circuits with AKS One Purpose Test
On December 27, 2024, the United States Court of Appeals for the Second Circuit decided United States ex rel. Camburn v. Novartis Pharmaceuticals Corporation and joined a growing list of federal circuit courts that have adopted what the Second Circuit…