Healthcare Fraud Enforcement Under a New Administration: Increasing Criminal and Civil Actions, Mitigating Client Risk

Course Details
- smart_display Format
Live Online with Live Q&A
- signal_cellular_alt Difficulty Level
Intermediate
- work Practice Area
Health
- event Date
Wednesday, August 27, 2025
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
-
This 90-minute webinar is eligible in most states for 1.5 CLE credits.
This CLE webinar will examine the new administration's focus on healthcare fraud, agency priorities, and the impact this will have on healthcare entities. The panel will discuss DOJ's increased focus on criminal enforcement action as well as civil enforcement trends. The panel will also look at HHS-OIG's first semiannual report to Congress under the new administration and address what may be expected in terms of agency enforcement. Finally, the panel will offer best practices for helping healthcare clients remain compliant under increased government scrutiny.
Faculty

Ms. Sorensen builds on her previous experience at the Office of Counsel to the Inspector General of the Department of HHS to assist clients with health care regulatory, compliance, and fraud and abuse matters. She focuses her practice on health care fraud and abuse and compliance matters, including the Anti-Kickback Statute. Ms. Sorensen assists clients in False Claims Act investigations, negotiating FCA settlements and corporate integrity agreements, and matters that fall under the Civil Monetary Penalties Law and OIG exclusion authorities. She helps clients develop compliance programs and implement corporate integrity agreements. Ms. Sorensen previously served as chief of the Administrative and Civil Remedies Branch in the Office of Counsel to the Inspector General (OCIG) at HHS. She served as the OCIG’s coordinator for both the Provider Self-Disclosure Protocol and the Physicians at Teaching Hospitals national project and also served the OCIG as senior counsel and deputy branch chief.

Mr. Porter focuses on white collar criminal defense, federal investigations brought under the False Claims Act, and litigation against the government and whistleblowers, with an emphasis on matters within the healthcare industry. As a former federal prosecutor with the DOJ, he was a key member of multiple international healthcare fraud takedowns and prosecuted a series of high-profile financial crime cases. Mr. Porter also handled major civil investigations and litigation against companies and individuals under the False Claims Act, resulting in record-breaking settlements and judgments. He now uses that experience to guide clients through federal investigations of all kinds, to litigate cases against and involving the government, and to run effective and right-sized internal investigations for corporations. Many of Mr. Porter’s clients are in the healthcare industry, including health systems, physician groups, and other healthcare companies, along with medical professionals and executives. He serves as a vice chair of the American Health Law Association’s Fraud and Abuse Practice Group.

Ms. Barnes counsels clients in high-stakes matters related to fraud allegations, including in healthcare, federal contract procurement, and securities and financial services. A former trial attorney with the U.S. DOJ, she has extensive experience handling issues related to compliance, white-collar and regulatory investigations, and complex commercial litigation. Ms. Barnes represents businesses in public and non-public investigations, regulatory inquiries, and proceedings involving federal and state agencies. She frequently assists clients navigating government investigations related to allegations arising under the False Claims Act, Anti-Kickback Statute, Stark Law, and FIRREA. Ms. Barnes is also a recognized leader in her practice, frequently participating in various speaking engagements and authoring articles on critical topics such as cybersecurity, government contract billing, financial data rights, and developments related to the FCA.
Description
The new administration has indicated that it will be increasing its attention on rooting out healthcare fraud including a heightened focus on pursuing criminal actions against noncompliant healthcare entities. The DOJ's Criminal Division recently released its first ever White-Collar Enforcement Plan (the Plan) which indicates increased focus on 10 new priority areas of which three are related to healthcare, specifically "healthcare fraud," "fraud that threatens the health and safety of consumers," and "violations of the Controlled Substances Act and the Federal Food, Drug, and Cosmetic Act."
The Plan also introduces amendments to the DOJ's Whistleblower Program guidance which broaden the types of reports that may be eligible for rewards, including additional healthcare violations, and references a revised Corporate Enforcement and Voluntary Self-Disclosure Policy to incentivize companies to self-disclose potential violations.
Although civil enforcement, including FCA litigation, is overseen by the DOJ's civil division, the criminal division's priorities and policies are indicative of the administration's general focus so that healthcare entities can expect no slowdown in civil enforcement action by DOJ as well. Additionally, HHS-OIG indicated in its first semi-annual report to Congress under the Trump Administration in June 2025 that it would continue to investigate healthcare fraud, with a particular focus on Medicare Advantage in which it has identified "a high risk of fraud, waste, and abuse."
With this increased government scrutiny on healthcare entities, counsel should understand where the focus of federal enforcement action may be and how to help their healthcare clients strengthen their compliance programs to mitigate risk.
Listen as our expert panel examines the new administration’s increased focus on healthcare fraud and offers best practices for helping healthcare clients navigate this evolving regulatory landscape.
Outline
I. Introduction
A. New administration's focus on healthcare fraud
II. DOJ
A. Criminal enforcement and the White-Collar Enforcement Plan
1. Healthcare fraud focus
2. Whistleblower program
3. Self-disclosure
B. Civil enforcement trends
1. DOJ-HHS False Claims Act Working Group
III. HHS-OIG and CMS
A. First semiannual report to Congress under new administration
B. Medicare Advantage
IV. Impact on healthcare entities
A. Strengthening compliance programs
V. Practitioner takeaways
Benefits
The panel will review these and other key issues:
- How has the DOJ indicated an increased focus on healthcare fraud, particularly relating to criminal enforcement actions?
- What does HHS-OIG's first semiannual report to Congress under the new administration indicate as to its enforcement focus?
- What civil and criminal enforcement trends may healthcare entities expect under the new administration?
- What are best practices for assisting healthcare clients with strengthening their compliance programs under increased government scrutiny?
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