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
Health Care Litigation
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…
No Surprises Here! Air Ambulance Providers Petition Supreme Court to Review Fifth Circuit’s No Surprises Act and ERISA Standing Decision
By Vinay Kohli & D. Austin Rettew on
In another development in the ongoing litigation over the enforceability of Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”), two air ambulance providers, Guardian Flight LLC and Med‑Trans Corporation, have filed a petition for writ of certiorari with the U.S. Supreme Court, seeking review of the…
No Surprises Here! Shareholder Derivative Lawsuit Challenging Provider Use of No Surprises Act IDR Process Portends New Corporate Governance Risks
By Vinay Kohli & D. Austin Rettew on
On September 8, 2025, a shareholder of Nutex Health, Inc. (“Nutex”) filed a derivative action in the Southern District of Texas that places the No Surprises Act (“NSA”) squarely at the center of a corporate-governance fight. Specifically, the complaint alleges that Nutex’s heavy reliance on the NSA’s independent dispute resolution…
No Surprises Here! New York and Florida Courts Reject Provider Suits to Enforce NSA IDR Awards, Heightening Pressure for Appellate Review
In a pair of recent back-to-back rulings, Federal district courts in Florida and New York have held that the No Surprises Act (“NSA”) does not permit providers to bring private causes of action to enforce Independent Dispute Resolution (“IDR”) awards issued under the NSA. Following on the heels of earlier…
Proskauer Secures Landmark Settlement with New York State to Expand Access to Children’s Mental Health Services
By Michael Menconi on
[This blog post was originally published on Proskauer’s Social Responsibility and Pro Bono blog here.]
A Proskauer team, along with Disability Rights New York (DRNY), Children’s Rights (CR) and the National Health Law Program (NHeLP), reached a preliminary settlement agreement with the State of New York in C.K. v.
DOJ Begins Issuing Demand Letters to Contractors Under New Civil Rights Fraud Initiative
[This blog post was originally published on Proskauer’s Government Contractor Compliance & Regulatory Update blog here.]
The U.S. Department of Justice (the “DOJ”), Civil Division, has started issuing Civil Investigative Demands (“CIDs”) to federal contractors and grant recipients, seeking detailed information about their diversity, equity, and inclusion (“DEI”) practices. This move is part…
No Surprises Here! Payers Push Back on IDR Submissions, Opening New Front in NSA Implementation Landscape
On May 27, 2025, Blue Cross Blue Shield Healthcare Plan of Georgia (“BCBSGA”) sued several emergency physician groups and their billing agent, Halo MD, alleging abuse of the No Surprises Act’s (“NSA”) independent dispute resolution (“IDR”) process. The complaint claims the providers submitted ineligible claims, made false attestations, and inundated…
DOJ Targets Gender‑Affirming Care under FDCA and FCA: Scrutinizes Off‑Label Drug Use and False Diagnosis Codes
Last month, the United States Department of Justice (“DOJ”) issued its “Civil Division Enforcement Priorities” memorandum, memorializing a shift from its predecessor administration’s policy on gender‑affirming healthcare (“DOJ Memo”). The DOJ Memo portends a significant rise in government investigations and False Claim Act (“FCA”) liability for suppliers and providers…
No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide on Award Enforcement Mechanisms
In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No Surprises Act (“NSA”). In a much-anticipated decision, the Fifth Circuit has held that the NSA does…