On April 30, 2026, the Department of Justice (“DOJ”) announced the creation of the West Coast Health Care Fraud Strike Force, a coordinated enforcement initiative focused on healthcare fraud in Arizona, Nevada, and Northern California. The initiative brings together DOJ’s Health Care Fraud Unit and the relevant U.S. Attorney’s Offices for those states, in coordination
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False Claims Act Roundup Series: Q1 2026 – Increased Government Enforcement Efforts and Circuit Court Developments
2026 has opened with unmistakable signals that False Claims Act (“FCA”) enforcement in the health care sector is accelerating. On January 16, 2026, the Department of Justice (“DOJ”) announced a record-breaking $6.8 billion in FCA settlements and judgments for fiscal year (“FY”) 2025—the largest annual total in the statute’s history and roughly a 120% increase…
This New Year, California Imposes Guardrails on the Use of AI by Payors for Utilization Management Determinations
SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management.[1] As discussed in a prior Proskauer alert, the Bill represents one of the latest attempts by the California legislature to regulate the…
OIG Reports that Clinical Trials Lack Diverse Subjects: What Role Can Artificial Intelligence Play?
As the largest public funder of biomedical research in the world, the National Institutes of Health (“NIH”) annually funds over $38 billion in extramural research, including about $6 billion for clinical trials. On May 28, 2024, OIG published a report (“OIG Report”) summarizing its finding that, of the NIH‑funded clinical trials randomly selected by OIG for review, a…