CMS and DOJ Collaboration:
The DOJ’s takedown was supported by CMS, which prevented $4 billion in fraudulent payments and revoked billing privileges for 205 providers. CMS’s role in identifying TVH’s overpayments suggests that the agency is already involved, which could lead to a DOJ investigation if evidence of fraud (e.g., intentional misrepresentation or kickbacks) is found.
The DOJ’s Health Care Fraud Data Fusion Center, established in 2025, uses AI and advanced analytics to detect emerging fraud schemes, increasing the likelihood that large overpayments like TVH’s would be flagged for review.
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