Healthcare Noncompliance Report: A Year of Lessons from 130 Enforcement Actions
Brellium analyzed approximately 130 legal filings from the past year to provide healthcare compliance leaders, executives, and QA teams with actionable insights into emerging documentation risks and enforcement trends.
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Introduction
In recent years, healthcare documentation practices have faced intensified scrutiny from federal and state enforcement agencies. Brellium, recognizing the growing risks healthcare providers face, analyzed approximately 130 legal filings from the past year. Our aim is to provide healthcare compliance leaders, executives, and quality assurance teams with actionable insights into emerging documentation risks, helping providers proactively navigate compliance challenges.
Methodology and Data Collection
Our analysis combined sophisticated data scraping and targeted keyword research. Brellium employed a Python script to scrape over 1,400 authoritative sources—including DOJ press releases, state Attorneys General websites, healthcare trade media, and whistleblower law firm alerts—using keywords such as "Medicare fraud," "documentation fraud," and "phantom billing." Additionally, we leveraged Claude-assisted research to analyze less structured sources like news reports and healthcare databases.
Federal Scrutiny of Documentation is Escalating
- CMS is now auditing all ~550 Medicare Advantage plans annually—up from just 60 (CMS, 2025).
- HHS-OIG reported over $7.1B in expected recoveries and 1,500+ enforcement actions in 2024.
- DOJ secured $2.9B in False Claims Act settlements, with healthcare cases making up the majority.
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