DOJ Announces $3B in False Claims Act Recoveries
Client Alert | 1 min read | 01.10.20
The Department of Justice announced that it recovered more than $3 billion in settlements and judgments from False Claims Act matters in Fiscal Year 2019. The release may be found here. In addition to describing in detail significant cases, the press release covers:
- $2.6 billion in healthcare related recoveries
- 633 qui tam suits filed
- Research and grant misconduct by universities leading to more than $100 million in settlements
- Penalties and damages imposed against individuals/company executives
This annual press release is an important tool for companies to understand FCA enforcement trends. Among other things, the press release offers a broad window into the state of False Claims Act risks and provides an opportunity for companies to review their compliance programs and address emerging issues or gaps that may exist.
For more information, join Crowell & Moring lawyers for a webinar discussing emerging False Claims Act risks for 2020 and beyond on Wednesday, January 15 from 1-2:30pm eastern. Registration is available here.
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Client Alert | 2 min read | 02.03.26
CMS Doubles Down on RADV Audit Changes
On January 27, 2026, the Centers for Medicare and Medicaid Services (CMS) released a Health Plan Management System (HPMS) memo that provided a long-awaited update on how the agency plans to approach previously announced Risk Adjustment Data Validation (RADV) audits for Payment Years (PY) 2020-2024. The memo is the agency’s most comprehensive statement on the subject since September 25, 2025, when the Northern District of Texas vacated the 2023 RADV Final Rule. The memo makes clear that, while CMS has made certain operational adjustments in response to concerns expressed by Medicare Advantage Organizations (MAOs), the agency is largely pressing forward with the accelerated audit strategy announced in May 2025.
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Optimum’s Shot Across the Bow: An Antitrust Challenge to Cooperation Agreements
