In a 217-page complaint filed on May 1, 2025, the U.S. Department of Justice (DOJ) brought civil claims under the False Claims Act against major health insurers—Aetna, Elevance Health (previously known as Anthem) and Humana—alleging they paid hundreds of millions of dollars in kickbacks to some of the country’s largest insurance brokers to steer Medicare beneficiaries into their Medicare Advantage plans. Medicare Advantage—a $450 billion program through which private insurers deliver federal health benefits to seniors and people with disabilities—is a critical revenue driver for the nation’s largest health insurers. Read the full Alert on the Duane Morris website.
DOJ Signals Renewed Focus on False Claims Act Enforcement of Customs Fraud and Tariff Evasion by U.S. Importers
Allegations of improper avoidance of customs and duty obligations by businesses have long presented a potential risk of False Claims Act (FCA) liability. For businesses that do not directly or indirectly receive government funding, but whose operations rely on international supply chains, that risk may have once seemed remote. While customs and duty fraud FCA investigations and enforcement seemed to have been eclipsed by matters involving, for example, healthcare and government contracting, the current administration’s focus on international trade and tariffs—and recent FCA enforcement activity—should remind businesses at all stages of international supply chains of their potential risks. Read the full Alert on the Duane Morris website.
DOJ Brings Robust False Claims Act Enforcement in 2024
On February 22, 2024, Department of Justice Principal Deputy Assistant Attorney General, Civil Division, Brian M. Boynton announced the DOJ’s civil enforcement priorities at the Federal Bar Association’s Qui Tam Conference.
Boynton emphasized the DOJ’s volume of enforcement activity in fiscal year 2023, noting that 2023 marked a record number of False Claims Act (FCA) settlements and judgments and for the number of Civil Investigative Demands (CIDs) issued by DOJ—a staggering 1,504. These robust tools for investigating FCA matters were triggered by a blend of government-originated FCA investigations and qui tam lawsuits filed by relators. Boynton noted that last year, the government opened approximately 500 FCA matters without a whistleblower, which was another record for the DOJ. More than 700 additional FCA cases were filed by qui tam relators. Read the full Alert on the Duane Morris website.