On August 28, 2026, the Centers for Medicare & Medicaid Services (CMS) announced that recent enforcement actions have stopped more than $1.6 billion in potentially improper Medicare payments to diagnostic laboratories since the beginning of the current administration. The announcement highlights a significant increase in CMS’s reliance on data analytics and artificial intelligence to detect
Health Care
CLIA at a Crossroads: CMS and CDC Seek Input on the Future of Laboratory Regulation
On July 16, 2026, the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) published a Request for Information (RFI) concerning potential updates to the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations. The RFI (CMS-3485-NC) reflects the agencies’ effort to assess whether the CLIA framework should be…
AI-Assisted Data Mining and the False Claims Act: Is a Data Anomaly Really a False Claim?
Data miner whistleblowers, increasingly armed with artificial intelligence (AI) tools, are already reshaping how False Claims Act (FCA) theories are built, generated, and litigated. The Department of Justice’s (DOJ) April 2026 announcement of the Fraud Oversight through Careful Use of Statistics (FOCUS) initiative, which will strengthen relationships with data miner relators who have developed…
Virtual and Digital Health Digest – August 2026
Welcome to the latest installment of Arnold & Porter’s Virtual and Digital Health digest. This digest covers key virtual and digital health regulatory and public policy developments during July and early August 2026 from the EU and UK.
During July 2026, regulators in the EU and UK continued to focus on the practical implementation of AI…
DOJ’s FOCUS Initiative Seeks Data Miners
The Department of Justice recently announced the creation of the Fraud Oversight through Careful Use of Statistics or FOCUS Initiative (“FOCUS”). According to DOJ’s Press Release, since 2024, data miners have filed over 45% of the federal False Claims Act qui tam complaints.
A Shift in Whistleblower Filings Driven by Data Mining
Traditionally, most False…
$1.6 Billion in Medicare Fraud Stopped: What CMS’s Lab Crackdown Means for Legitimate Providers
The numbers are hard to ignore. The use of AI has substantially increased the number of audits over health care providers. Hence, the increase of amount of money found to be noncompliant. Since the start of the current administration, the Centers for Medicare & Medicaid Services (CMS) has blocked more than $1.6 billion in potentially…
Private Equity Dealmaking Slows in 2026
We have been reporting regularly on the increasing role that private equity has been playing in the healthcare industry and the oversight initiatives that a number of states have taken to address certain concerns resulting from this trend.
In a just-published article, Modern Healthcare cites data from Pitchbook and reports a 46% decrease in private…
Deal Activity, AI and Regulatory Pressure with Holly Buckley
In this episode of the Becker Private Equity & Business Podcast, Holly Buckley, Chair of Healthcare at McGuireWoods, discusses the latest healthcare private equity trends, including transaction volume, physician practice investments, AI adoption, state regulations and the outlook for deals and exits.
Kaiser to Present on Navigating Legal Challenges in Drug and Device Industries
On September 17, Rivkin Radler’s Jeff Kaiser will participate on a panel at the Practising Law Institute (PLI) “Life Sciences 2026: Navigating Legal Challenges in Drug and Device Industries” program in New York City. The panel is entitled “Enforcement Trends Impacting the Drug and Device Industries.”
Offered virtually and at PLI’s NY Conference Center at…
DOJ’s 2026 Health Care Fraud Takedown Signals Medicaid Enforcement Priorities
This post is co-authored by Seth Orkand, co-chair of Robinson+Cole’s Government Enforcement + White-Collar Defense Team, and Abigail Clarke, a 2026 Summer Associate at Robinson+Cole. Abigail is not admitted to practice law.
The Justice Department’s (DOJ) June 23, 2026, announcement of its annual Health Care Fraud Takedown makes clear that Medicaid and state health…