Spotlight on January 2025 FWA

Why This Topic Matters

These enforcement updates highlight current compliance risk areas across multiple specialties and billing environments. They help readers monitor government priorities and understand the kinds of allegation patterns that can affect coding, documentation, billing, and program integrity work.

Article Sections

1. LabCorp and University Health System Agree to Pay $388,667 to Resolve Alleged False Claims Act Violations

   A settlement update involving laboratory services, Medicare billing, and alleged false claims activity connected to delayed order submission and related government allegations.

2. Physicians Toxicology Laboratory and Its Owners to Pay $4.425 Million to Settle Allegations of Unnecessary Drug Testing

   A False Claims Act settlement involving laboratory drug testing, physician ordering practices, and government allegations of unnecessary testing and related billing.

3. Telehealth Company Pays $386,000 to Resolve Allegations of Overbilling for Medicare Telehealth Time

   An enforcement update concerning telehealth psychotherapy services, Medicare time-based billing, and alleged false claims supported by time records.

4. Owner of Addiction Treatment Chain That Billed for Recovery Services Not Provided Sentenced to More Than Eight Years in Federal Prison in Healthcare Fraud Conspiracy

   A criminal fraud matter involving addiction treatment services, session-length allegations, and billing to Medicare, Medicaid, and other payors.

5. Chesapeake Hospital Indicted for Healthcare Fraud Involving Unnecessary Surgical Procedures

   An indictment involving hospital-based surgical and obstetric services, medical necessity allegations, program integrity issues, and extensive insurer and government claims.

6. The United States and State of North Carolina File False Claims Act Complaint Against Durable Medical Equipment Supplier

   A civil complaint concerning durable medical equipment billing, North Carolina Medicaid, and allegations that the billed items did not match the items provided.

7. AG Nessel Reaches $19.85 Million Multistate Medicaid Fraud Settlement With Behavioral Health Facility

   A multistate behavioral health settlement addressing inpatient care, patient placement, treatment, staffing, and Medicaid and Medicare allegations.

8. BioReference Health and OPKO Health Agree to Pay $704,349 to Settle Allegations That They Billed the Government for Medically Unnecessary Blood Tests

   A laboratory settlement involving blood testing, provider orders, and alleged billing for more expensive testing than was ordered.

9. Justice Department Files Nationwide Lawsuit Alleging Walgreens Knowingly Filled Millions of Prescriptions That Lacked a Legitimate Medical Purpose

   A nationwide pharmacy enforcement action involving controlled substances, federal healthcare program reimbursement, and False Claims Act allegations.