Ty Howard Quoted in Clinician.com on the DOJ Targeting Healthcare for False Claims Act Enforcement

Bradley attorney Ty Howard was featured in Clincian.com on the Department of Justice (DOJ) taking a closer look at healthcare organizations for False Claims Act (FCA) violations.

Much of the discussion around Trump administration FCA enforcement has focused on potential new bases, such as tariff-related theories and targeting educational institutions with DEI programs, noted Howard.

“But make no mistake, healthcare is still the industry most at risk for FCA investigations, just as it has been for many years running. In many situations, that will involve traditional areas, like allegedly medically unnecessary services, upcoding or other billing errors, and arrangements tainted by the kickbacks,” he said. “Larger jurisdictions and those with particular healthcare expertise are more likely to investigate and prosecute newer theories for FCA liability, such as those involving private equity in healthcare, Medicare Advantage (Part C) cases, cybersecurity, and data breach cases in healthcare.”

Cases involving telemedicine, pandemic-related fraud, and areas like amniotic skin grafts and other emerging treatment options also have been identified by the DOJ as areas of focus, Howard said. For providers, Howard explained the best protection remains these tried-and-true strategies:

• Implement and follow a robust compliance plan; train on it regularly and update it as the law and your practice evolves.
• Monitor your own claims data to assess your risk exposure and course correct as needed.
• Have a reporting system for internal reporting and would-be whistleblowers so matters can be quickly addressed internally before outside involvement.
• Foster a culture of compliance and transparency.
• Get outside counsel involved early on any issues to ensure they are handled properly and, in most cases, can be addressed under the cloak of the attorney-client privilege. (Remember that work performed by billing and audit companies that are retained directly by the healthcare organization, rather than through counsel, likely will not to be protected from later disclosure.)

“In FCA enforcement, as in medicine, an ounce of prevention is worth a pound of cure,” Howard said.

The full article, “DOJ Targeting Healthcare for False Claims Act Enforcement,” was published by Clincian.com on August 1, 2025.