United States: White Collar Crime, Anti-Corruption & Fraud

This month, Aetna Inc. (Aetna) entered into two settlement agreements with the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) in which it agreed to pay $117.7 million to resolve False Claims Act (FCA) allegations related to Medicare Advantage (MA) risk adjustment activities. The government alleged that Aetna submitted or failed to delete inaccurate diagnosis codes for enrollees in its MA plan to increase its Medicare payments

The U.S. Department of Justice (DOJ) reported a record year for False Claims Act (FCA) enforcement in fiscal year 2025, with more than $6.8 billion in settlements and judgments — the largest annual total in the history of the statute. The DOJ also reported a record 1,297 qui tam actions filed by whistleblowers and 401 investigations opened by the government during the year.

A recent 8,000-word investigation by Reuters reignited one of the art world’s most persistent questions: who is Banksy? Drawing on court filings, police records, witness statements, travel data.....