Articles and Blogs

In two recent civil antitrust complaints, the Antitrust Division of the U.S. Department of Justice (“DOJ”) alleged that hospital systems used payer contracting provisions—so‑called steering restrictions that require hospitals to be included in nearly all of an insurer’s commercial networks at the most favored level of benefits—to restrict health insurers’ ability to offer narrow... READ MORE

Health care enforcement is entering a data-driven era in which artificial intelligence (“AI”) and large-scale analytics increasingly shape how fraud is identified and pursued, as reflected in the U.S. Department of Justice’s (“DOJ”) launch of the Fraud Oversight through Careful Use of Statistics (“FOCUS”) initiative. Overview of the FOCUS Initiative On April 7, 2026,... READ MORE

In an effort to intensify their efforts against health care fraud, the U.S. Department of Justice (“DOJ”) and the Department of Health and Human Services (“HHS”) announced on July 2, 2025, the creation of a DOJ-HHS False Claims Act (“FCA”) Working Group (the “Working Group”). While DOJ and HHS have a long history of... READ MORE