Scott Driggs

Artificial intelligence (AI) is rapidly becoming a significant factor in federal healthcare fraud and abuse enforcement. It is simultaneously becoming the government’s most powerful tool for detection of fraud and abuse, and a source of potential False Claims Act (FCA) exposure when AI-assisted processes contribute to inaccurate claims, unsupported diagnoses, or other compliance failures.

Introduction The Department of Justice (DOJ) recently secured a $32 million settlement resolving allegations under the “reverse” false claims provision of the False Claims Act (FCA), based on the alleged knowing failure of a healthcare provider and its executives to return identified Medicare overpayments from 2021 to the present.1 The settlement serves as a forceful reminder that the government is actively pursuing reverse FCA cases based on the retention of overpayments — not just the...

Building on our April alert regarding Colorado’s three-front AI healthcare landscape, the legislature has finalized all three tracks. The compliance picture has rapidly shifted, bringing unexpected framework changes that demand immediate attention. Front One: SB 24-205 Is Gone — Replaced by SB 26-189 The original Colorado AI Act never took effect.