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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 | 6 min read | 04.29.26

CMS Seeks to Expand Interoperability Requirements to Drug Pre-Authorization (FAQ)

On April 10, 2026, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule (2026 CMS Interoperability Standards and Prior Authorization for Drugs, or CMS-0062-P) outlining the agency’s plans to impose new interoperability requirements on payors participating in certain Medicare and Medicaid programs. As described by the agency in a recent press release, the proposed rule “builds on” prior rulemaking by clarifying and enhancing interoperability requirements for payors’ prior authorization processes, specifically those associated with coverage requests for pharmaceutical therapies....

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