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DOJ Reports $4.7B in FCA Recoveries in FY16

Client Alert | less than 1 min read | 12.16.16

On December 14, 2016, DOJ reported that it recovered more than $4.7 billion in settlements and judgments from civil FCA cases in FY16, making it the third highest annual recovery in FCA history. Of the FY16 recoveries, $2.5 billion related to health care fraud, $1.7 billion related to the financial industry, and the remaining $500M related to higher education, procurement, and other federal programs.

Insights

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....