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DOJ Reaffirmation of Relator Authority: The Shumate Memo reaffirms DOJs position that whistleblowers may stand in the shoes of the government and indicates that the agency will let relators lead litigation subject to DOJs oversight and ultimate control. Automatic Criminal and Administrative Referrals: New benefits program fraud qui tam matters will be automatically referred to the Criminal Division and/or the National Fraud Enforcement Division for evaluation of potential criminal violations and to the affected agency for potential administrative action, including payment suspension

Plewka A, Madej P, Plewka D, Kowalczyk A, Miskiewicz A, Wittek P, et al

Missing documentation elements trigger payer audits and recoupment demands even when the service was legitimately provided

These savings were mostly attributed to avoidable physician visits for injections