Health Care Fraud in a Time of Increased Judicial Scrutiny | The Regulatory Review

Twitter Facebook LinkedIn Email Print charged over a dozen individuals with perpetrating a scheme involving $10.6 billion in fraudulent health care claims—the largest case of alleged health care fraud ever uncovered in the United States.

Although this case illustrates federal prosecutors’ vigilance in seeking to tamp out health care fraud, scholars express concerns that the U.S. Supreme Court’s 2024 decision in Loper Bright v. Raimondo could undermine future enforcement of health care fraud laws. In a forthcoming article, Joan H. Krause of the University of North Carolina School of Law argues that Loper Bright will prompt enforcement agencies to rely on informal guidance documents to share their interpretations of health care fraud laws, creating instability in future enforcement.

Krause explains that, for forty years, federal courts deferred to agency interpretations of ambiguous…