Social Media Ideas for Eliminating Kickbacks In Recovery Act

OIG Raises Anti-Kickback Concerns About Subscription-Based Referral Management Platforms

Key Takeaways: OIG’s Advisory Opinion 26-15 asserts that a subscription-based referral management software arrangement could implicate the federal Anti-Kickback Statute. Health ca...

Allstate Alleges Florida Ortho Kickback Scheme

Allstate is suing a Florida Orthopedics practice alleging that they engaged in a kickback scheme where a $16,500 radiofrequency ablation bill….

DOJ Civil Division Accelerates Review of FCA Whistleblower Complaints Involving Federally Funded, State-Administered Ben...

Manufacturer’s $2,500 Reimbursement Proposal for Device Failures

RFO Rulemaking Proposes Shorter Deadlines for Contractors to Submit Termination Settlement Proposals

HHS-OIG Advisory Opinion 26-09: Free Orthodontic Treatment Program Cleared Under Anti-Kickback Statute With Proper Safeg...

Highlights The U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) released a favorable opinion regarding a dental practice offering free orthodo...

United States v. Simons: Key Evidentiary Guidance in an Emerging Area of EKRA Enforcement

As Eliminating Kickbacks in Recovery Act (“EKRA”) enforcement continues to expand, the United States District Court for the Southern District of California in United States v. Simo...

Is the WISeR Prior Authorization Pilot Dead or Alive?

The House Appropriations Committee voted to effectively defund the Wasteful and Inappropriate Service Reduction (WISeR) prior authorization pilot, a program that has faced bipartis...

New Proposal Signals Big Changes Ahead for Embattled Drug Discount Program

“The breadth of the proposal suggests that many organizations will need to reassess existing policies, contractual relationships, and compliance programs if these reforms advance,...

Ohio payers lose a year of recovery reach

SB 162 halves the clawback lookback and bars fees on provider appeals

DOJ Puts Benefits Fraud Cases on a Fast Track: New Benefits-Fraud Policy May Increase Qui Tams and Reshape FCA Practices

Recovery Centers of America Agreed to Pay $2 Million to Resolve Allegations

THEN AND NOW – Dec. 10, 2025  – US Attorney David Metcalf announced today that Recovery Centers of America (RCA) has agreed to pay $1,000,000 to resolve allegations that it failed...

Revolutionary FAR Overhaul Implements Fixed-Price Contracting Preference Under FAR Part 16

DOJ Accelerates False Claims Act Enforcement: New Protocol Signals Faster Action on Benefits Fraud Whistleblower Cases

Post Acute Update: HHS-OIG Issues Unfavorable Advisory Opinion on Subscription-Based Referral Management Software

The U.S. Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 26-15 addressing a subscription-based referral management soft...

Prior authorization reform gets promising start from House health panel

Statement is attributable to: - John Whyte, MD, MPH - CEO, American Medical Association - - “The American Medical Association commends the House Energy and Commerce Health...

Medicare's New Approach to Halting Fraud Paying Off

Last year, we wrote in the Los Angeles Times that the Centers for Medicare and Medicaid Services was done chasing criminals after we'd already handed them money. We said we were bu...

Medicare Fraud, Kickbacks Rampant at 340B Hospitals

The 340B Drug Discount Program was created to help low-income patients. Instead, it too often helps multibillion dollar “non-profit” hospitals to fund ad campaigns, pad executive p...

New Connecticut Law Expedites Claim Disputes Between Health Care Providers and Insurers

On May 27, 2026, Connecticut Governor Ned Lamont signed “An Act Concerning Return of Health Care Provider Payments” (PA 26-56). As of January 1, 2027, PA 26-56 shortens the time pe...

Allstate sues Florida orthopedic group, alleges kickback-driven billing scheme

Insurer says a 13-clinic orthopedic group used kickbacks and phantom procedures to pad bills

DOJ Accelerates False Claims Act Investigations Involving Medicaid and Other State-Based Benefit Programs

Enough is Enough: HHS-OIG Freezes Funds for New York Medicaid Fraud Control Unit, Effective July 1