DOJ just sent a message to anyone with information about fraud on federally funded benefits programs: We want to hear from you, and we're ready to act fast. Yesterday, DOJ's Civil Division announced reforms to accelerate the review of False Claims Act (FCA) whistleblower complaints involving fraud against publicly funded, state-administered benefits programs, including Medicaid, […]
We now live in a world where technology, especially artificial intelligence, permeates most of our daily lives. So it should come as no surprise that the business of fraud is experiencing the same tech-inundation. The perpetrators of fraud, the government investigators of fraud, and the whistleblower watchdogs who report fraud have all taken up the […]
A California-based aluminum importer and its affiliated companies have agreed to settle False Claims Act allegations that they evaded antidumping and countervailing duties on aluminum extrusions imported from China for $549.5 million. On paper, this is one of the largest customs fraud settlements in U.S. history. Let’s take a closer look at this case and […]
Data-mining whistleblowers are no longer a sideshow. They’re rapidly becoming a dominant force in False Claims Act filings. And the Department of Justice has a message: sophisticated analytics are welcome, but speculative pattern-detecting is not. Traditionally, whistleblowers are insiders, generally employees who spot misconduct at work and come forward. Data miners flip that model, using […]
Each year, CMS, the agency that operates Medicaid and Medicare releases an Improper Payment Report, which uses statistics, data analyses, and information learned from government enforcement actions, to estimate the amounts of payments that do not meet CMS program requirement. These include estimated money lost to fraud, but also to negligence, mistake, or other more […]
On April 17, 2026, the IRS Whistleblower Office issued a rare Whistleblower Alert. The alert is brief and informs the public that the IRS is seeking tips about fraud involving “the misuse, diversion or fraudulent use of federal funds and grants by tax-exempt organizations, individuals, and businesses.” It lists examples of wrongdoing including “misclassification of […]
At the end of March, FinCEN published a notice of proposed rulemaking (“NPRM”) for its whistleblower program, which has been up and running since 2021. The proposed rules are a welcome development. They are a sign that the Treasury Department appreciates the value of the whistleblowers who have come forward under the program so far […]
The Justice Department’s (DOJ) recent resolution with AssuredPartners and its former subsidiary, AP of South Florida (APSF), marks a notable False Claims Act (FCA) case arising from alleged fraud in the Affordable Care Act (ACA) marketplace. APSF agreed to plead guilty to major fraud against the United States and pay $27.6 million in restitution, while […]
On March 11, 2026, the Department of Justice announced the latest in a long line of Medicare Advantage fraud settlements against MAOs—this time with Aetna, which agreed to pay $117.7 million to resolve False Claims Act allegations involving risk adjustment practices. This case is part of DOJ’s ongoing focus on Medicare Advantage “upcoding”—that is, making […]
Last week, FinCEN announced a historic $80 million penalty against Canaccord, LLC, a broker-dealer, for violations of the Bank Secrecy Act. The penalty is the largest ever imposed against a broker-dealer for BSA violations. This news is a ringing reminder to broker-dealers that despite the Bank Secrecy Act having “Bank” in its name, it applies […]
