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Health Care Fraud

Feb 26, 2026

Arizona Hospital Agrees to Pay $5.6M to Resolve False Claims Act Allegations Related to AKS & Stark

On Tuesday February 24, 2026, the U.S. Department of Justice announced that an Arizona surgical hospital–Southwest Orthopedic and Spine Hospital, doing business as OASIS Hospital–as well as United Surgical Partners International (USPI) and a jointly-owned surgery center (Dignity/USP Phoenix Surgery Centers) agreed to pay $5.6 million to resolve allegations that they violated the False Claims […]

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Jan 18, 2026

False Claims Act Recoveries Exceed $6.8B in FY2025; Highest Ever

Last Friday, the Department of Justice (DOJ) released its annual False Claims Act report, announcing that FCA settlements and judgments had exceeded $6.8B in fiscal year 2025 (ending 9/30/25), and noting that the total is “the highest in a single year in the history of the False Claims Act.” Here is a breakdown of some […]

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Jan 15, 2026

Kaiser Agrees to $556 Million False Claims Act Settlement

On January 14, 2026, the Department of Justice announced that several affiliates of Kaiser Permanente agreed to pay $556 million to resolve allegations that they violated the False Claims Act (FCA) “by submitting invalid diagnosis codes for their Medicare Advantage Plan enrollees in order to receive higher payments from the government.” As outlined in the […]

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Jan 13, 2026

Skin Substitute Medicare Audits: Is Round Two on the Horizon?

As we have written about several times previously, billing Medicare for skin substitutes used in wound care has come under significant scrutiny by various federal agencies, including the Department of Justice, HHS’ Office of Inspector General (OIG), and CMS and its contractors. Recently, Medicare instituted substantial changes to its reimbursement methodology, a move that it […]

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