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Jun 10 2026

Upcoding by Software: When Electronic Health Records Are Used to Inflate Medicare Billing

In November 2025, the Department of Justice announced a $45 million settlement with Vohra Wound Physicians Management, LLC, and its founder, Dr. Ameet Vohra. Vohra operated one of the largest wound care services in the country, treating patients in nursing homes and skilled nursing facilities nationwide. The government alleged that Vohra ran a systematic upcoding scheme to defraud Medicare by programming its own electronic health record and billing software to ensure that Medicare was always … [Read more...]

Jun 10 2026

FinCEN Whistleblower Program: What It Means for Reporting Medicare and Medicaid Fraud

On March 30, 2026, the U.S. Department of the Treasury's Financial Crimes Enforcement Network (FinCEN) issued two significant announcements. The first was a formal advisory to financial institutions nationwide, directing them to increase their vigilance for fraud targeting Medicare, Medicaid, and other federal healthcare programs. The second was a Notice of Proposed Rulemaking that would, for the first time, establish a comprehensive framework for paying financial awards to individuals who … [Read more...]

Jun 10 2026

Medicare Billing Fraud in the Lab: Unnecessary or Fabricated Diagnostic Tests

In January 2026, the Department of Justice announced that Clinical Laboratory LTD Holding LLC, formerly known as Labtech Diagnostics LLC, and its founder and CEO, Joseph Labash, agreed to pay at least $6.8 million to resolve False Claims Act allegations involving illegal kickbacks to physicians. The settlement brought total civil recoveries related to Labtech to more than $11.5 million, including amounts recovered separately from nine doctors whose referral relationships with the lab were also … [Read more...]

Jun 10 2026

Durable Medical Equipment Fraud: The Long-Running Schemes That Keep Costing Taxpayers

A network of foreign operatives, communicating through encrypted messaging and using assumed identities, sent representatives into the United States with a specific assignment: buy as many medical supply companies as possible, as quickly as possible, and start billing Medicare. Over the course of the scheme, the organization acquired dozens of suppliers across the country and submitted more than $10.6 billion in fraudulent claims for urinary catheters and other durable medical equipment, using … [Read more...]

Jun 10 2026

Government Contract Fraud: How Contractors Shift Unallowable Costs to Taxpayers

At most government contractors, the people who decide which contract number gets charged for a given expense are not executives. They are project managers, timekeeping administrators, and accounting staff working through spreadsheets and cost allocation systems, often under pressure to hit budget targets or keep commercial work profitable. The decisions they make, sometimes under explicit direction from above and sometimes as a matter of quiet institutional habit, can cross a legal line that … [Read more...]

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