In this Winter 2025 edition, we cover:
- Enforcement Trends: DOJ reports nearly $3 billion in FCA recoveries for FY 2024, and EOs signal use of FCA to enforce Trump policies. Also, McKinsey settlement marks first time management consulting firm held criminally responsible for advice to client, and potentially signals new area of FCA liability.
- Litigation Developments: First circuit joins sixth and eighth circuits in adopting heightened, but-for causation standard for AKS-based FCA claims brought under 2010 amendment.
- Compliance Corner: Hospital under the DOJ scalpel: lessons from the indictment of a hospital illustrate importance of effective compliance and oversight.
- ICYMI: Florida Surgeon Who Saved Rapper 50 Cent’s Life Is Sentenced to Seven Years Imprisonment for Fraudulent Insurance Billing
1. Enforcement Trends
DOJ Reports Nearly $3 Billion in FCA Recoveries for FY 2024, and EOs Signal Use of FCA to Enforce Trump Policies
In Fiscal Year 2024, the US Department of Justice (DOJ) recovered $2.9 billion from 558 FCA settlements and judgments. “The Department places a high priority on fighting fraud and abuse in federal programs,” said Principal Deputy Assistant Attorney General Brian Boynton, head of the Justice Department’s Civil Division. “The results announced today highlight once again that such conduct will not be tolerated, and that those who knowingly misuse taxpayer funds will be held accountable.”
Health care fraud matters remained the leading source of FCA...
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