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HHS-OIG identified $6.9 billion in potential savings if improvements are made to Medicare Advantage risk adjustments.

LEIE Updated with April 2025 Exclusions

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HHS-OIG Investigation Results in $202M Settlement with Gilead Sciences for Alleged Physician Kickbacks
HHS-OIG Investigation Results in $350 Million Settlement with Walgreens
HHS-OIG Investigation Leads Florida Insurance Brokerage Executive to Plead Guilty in $133 Million Affordable Care Act Fraud Scheme

What's New

May 9, 2025
LEIE Database Updated with April 2025 Exclusions and Reinstatements
Updated: Corporate Integrity Agreements
Updated: CMP and Affirmative Exclusions/EMTALA Patient Dumping
Updated: Fraud Self-Disclosures
May 7, 2025
Most Medicare Part D Plans’ Formularies Included Humira Biosimilars for 2025 OEI-05-23-00520
Read More What's New

Enforcement Actions

May 13, 2025; U.S. Department of Justice
New Hampshire Doctor Pleads Guilty to Illegally Prescribing Opioids
May 9, 2025; U.S. Attorney's Office, Middle District of Louisiana
Three Baton Rouge Individuals Plead Guilty In Federal Court In Connection With The Department Of Justice’s 2024 National Health Care Fraud Enforcement Action
May 9, 2025; U.S. Department of Justice
Pharmaceutical Manufacturer Assertio Therapeutics Inc. Agrees to Pay $3.6M to Resolve Allegations that It Violated the False Claims Act in Connection with Marketing its Fentanyl Product
Read More Enforcement Actions