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  • ⚖️ Cracking Down & Cashing In: Feds Stretch Fraud Laws from Clinics to Campuses 💸

⚖️ Cracking Down & Cashing In: Feds Stretch Fraud Laws from Clinics to Campuses 💸

From Medicare kickbacks to DEI crackdowns, the government’s fraud radar is in overdrive and your billing codes, subsidies, and social programs might be next.

False Claims Act Enforcement Expands into Civil Rights and Trade ⚖️🚨

The Department of Justice is broadening its use of the False Claims Act to pursue alleged fraud not only in healthcare and PPP, but also in grants or contracts tied to DEI, antisemitism, transgender care for minors, and customs compliance.

Key Points
  • From Jan 1 to May 31, 2025, DOJ secured 128 FCA settlements totaling ~$1.257 billion; healthcare and PPP cases made up ~70% of settlements and over 80% of total recoveries.

  • DOJ filed an FCA suit on May 1, 2025, against Aetna, Elevance, Humana, and brokers like GoHealth and eHealth, alleging Medicare Advantage kickbacks; the case was relator-initiated and DOJ-intervened.

  • In February 2025, DOJ launched a Civil Rights Fraud Initiative targeting DEI programs, campus antisemitism, and false federal compliance certifications, encouraging whistleblower actions with up to 30% recovery share.

  • Starting Jan 28 and reinforced in April and May 2025 memos, DOJ directed FCA enforcement against transgender-related billing for minors and facilities with sex-based access policies.

Why It Matters

These shifts reframe cultural and compliance issues as financial and legal risks, creating new pathways for whistleblowers and forcing organizations to reassess exposure in areas once considered outside traditional fraud enforcement.

Takeaway

Organizations receiving federal funds should urgently audit DEI programs, transgender billing, and customs procedures, bolster internal whistleblower reporting, and tighten controls to pre‑empt new FCA risks.

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