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 […]
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 […]
On January 7, 2026, the Department of Justice announced that South Carolina clinical laboratory Labtech Diagnostics, and its founder and CEO had agreed to pay at least $6.8 million to resolve allegations that they violated the False Claims Act (FCA) and various other laws by paying illegal kickbacks to doctors. In addition to the civil […]
The Centers for Medicare & Medicaid Services (“CMS”) just implemented significant changes to the way Medicare reimburses providers for skin substitutes. The changes were triggered in part by a September 2025 report by the Department of Health & Human Services’ Office of Inspector General (“HHS-OIG”), which sounded the alarm on skyrocketing Medicare Part B spending […]
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