The Department of Justice’s new “West Coast” strike force targets Arizona, Nevada and Northern California — regions flagged for rising Medicaid, hospice and tech-enabled fraud risks. Legal experts say the effort signals a broader shift toward data-driven enforcement, as regulators ramp up their scrutiny of telehealth companies and billing automation software.
The Department of Justice and the state of Ohio filed an antitrust lawsuit against OhioHealth this week, alleging the health system used “all-or-nothing” contracts that force insurers to include all of its hospitals and physicians. The case highlights federal and state scrutiny of hospital consolidation and restrictive contracting practices — with potential implications for payers, patients and healthcare markets across the country.
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Georgia policymakers, county officials and the NAACP are asking the federal government to investigate Wellstar Health System’s closure of two Atlanta-area hospitals in predominantly Black neighborhoods. Complaints have recently been filed with the DOJ, IRS and HHS' civil rights office.
The Department of Justice filed a lawsuit against Rite Aid, accusing the pharmacy chain of filling hundreds of thousands of opioid prescriptions that had “obvious, and often multiple, red flags.” The DOJ claimed that Rite Aid violated the Controlled Substances Act by filling unlawful prescriptions for addictive drugs, as well as the False Claims Act when the chain sought reimbursement from federal healthcare programs for these prescriptions.
The government has intervened in complaints alleging Kaiser Permanente entities defrauded Medicare out of "tens of millions of dollars" by knowingly submitting false diagnoses for Medicare Advantage beneficiaries. Kaiser denies the allegations, saying it is in compliance with program requirements.