Stewart Kameen Discusses Healthcare Fraud and Abuse Trends from 2025 and What to Expect in 2026

AHLA Speaking of Health Law Podcast

Bass, Berry & Sims attorney Stewart Kameen led a discussion on the American Health Law Association’s (AHLA) Speaking of Health Law podcast about healthcare fraud and abuse trends from 2025 and what to expect in 2026. Stewart currently serves as chair of the AHLA Fraud and Abuse Practice Group. Stewart was joined on the podcast by the Practice Group vice chairs Brandon Helms, Shareholder at Hall Render Killian Heath & Lyman PC; and Matthew Westbrook, Senior Counsel at Proskauer Rose LLP.

During the conversation, the attorneys discussed:

  1. Current healthcare fraud and abuse landscape: departure of many government attorneys that could result in a loss of institutional knowledge.
  2. The administration’s priorities: opioid trafficking; Medicare Advantage; COVID-19 fraud; diversity, equity and inclusion (DEI) risk for compliance under False Claims Act; immigration; the work of the False Claims Act Working Group and collaboration between Office of Inspector General (OIG) and Department of Justice (DOJ).
  3. General trends: Medicare Advantage enforcement actions; CMS strategy to enhance RAD-V audits; use of artificial intelligence (AI) to sift through claims data; enforcement shift from Medicare Advantage organizations to providers; DOJ focus on lab companies, wound care space, and durable medical equipment industry.
  4. Key settlements, cases, and advisory opinions: 2025 National Takedown was largest of its kind; questions surrounding constitutionality of the False Claims Act qui tam provisions; EMTALA enforcement actions; 84 provider self-disclosures; 10 advisory opinions from OIG (as of mid-December).
  5. Trends to watch for 2026: expected sub-regulatory guidance; data analytics and AI as a tool for investigations by government; companies should incorporate AI aspects into compliance programs; information blocking enforcement as a reminder of recent rules; issues involving the Anti-Kickback Statute.

The full episode, “Health Care Fraud and Abuse Trends From 2025 and What to Expect in 2026,” was released by AHLA’s Speaking of Law podcast on January 6 and is available online or wherever you get your podcast content.

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AHLA Speaking of Health Law Podcast

Bass, Berry & Sims attorney Stewart Kameen led a discussion on the American Health Law Association’s (AHLA) Speaking of Health Law podcast about healthcare fraud and abuse trends from 2025 and what to expect in 2026. Stewart currently serves as chair of the AHLA Fraud and Abuse Practice Group. Stewart was joined on the podcast by the Practice Group vice chairs Brandon Helms, Shareholder at Hall Render Killian Heath & Lyman PC; and Matthew Westbrook, Senior Counsel at Proskauer Rose LLP.

During the conversation, the attorneys discussed:

  1. Current healthcare fraud and abuse landscape: departure of many government attorneys that could result in a loss of institutional knowledge.
  2. The administration’s priorities: opioid trafficking; Medicare Advantage; COVID-19 fraud; diversity, equity and inclusion (DEI) risk for compliance under False Claims Act; immigration; the work of the False Claims Act Working Group and collaboration between Office of Inspector General (OIG) and Department of Justice (DOJ).
  3. General trends: Medicare Advantage enforcement actions; CMS strategy to enhance RAD-V audits; use of artificial intelligence (AI) to sift through claims data; enforcement shift from Medicare Advantage organizations to providers; DOJ focus on lab companies, wound care space, and durable medical equipment industry.
  4. Key settlements, cases, and advisory opinions: 2025 National Takedown was largest of its kind; questions surrounding constitutionality of the False Claims Act qui tam provisions; EMTALA enforcement actions; 84 provider self-disclosures; 10 advisory opinions from OIG (as of mid-December).
  5. Trends to watch for 2026: expected sub-regulatory guidance; data analytics and AI as a tool for investigations by government; companies should incorporate AI aspects into compliance programs; information blocking enforcement as a reminder of recent rules; issues involving the Anti-Kickback Statute.

The full episode, “Health Care Fraud and Abuse Trends From 2025 and What to Expect in 2026,” was released by AHLA’s Speaking of Law podcast on January 6 and is available online or wherever you get your podcast content.

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