Although most of the health reform furor was about the individual mandate, we have repeatedly made the point that health reform gave new weapons to prosecutors of fraud and abuse, and the financial pressures of the new environment make fraud and abuse enforcement a major focus of the regulators and enforcers. When GlaxoSmithKline paid more than $3 billion to settle false claims charges for a variety of misbehaviors, the government also made it clear, once again, that they would go after individual executives who ignore or worse yet encourage violative behavior.. Many in the commercial sector do not understand that the government is on a cultural jihad about this. It is remarkable that over the last twenty years, as measured by Public Citizen, fully more than 25% of Federal False Claims Act recoveries have come from big pharma. The government has new weapons and new approaches. "We used to hunt like an elephant and now we chase like a cheetah" is the line a senior advisor for investigation has used.  Alice authors a book which is updated every year titled Medicare and Medicaid Fraud and Abuse and the inexorable tightening of the enforcement snares is abundantly clear. What can regular providers do? As we have repeatedly recommended, now is the time to buff up your compliance program and if you don't have one it is imperative that you develop solid approaches to compliance. In "Compliance programs: more important now than ever" Alice and Dan explain why even though the law says having one is voluntary, those who don't adopt one, or merely pay lip service to the issue, do so at real peril. And, compliance is no longer just about false claims in billing.  The OIG has announced its invigorated focus on patient safety, noting that one in four Medicare beneficiaries suffers an adverse event in the hospital, and that it will continue and increase its attention to adverse events, never events and temporary harm events. Based on these developments it is clear that a good compliance program will encompass proactive management of a range of liabilities we have identified including Stark with attention to internal compensation as well as referral relationships, anti-kickback issues, maintaining enrollment and, increasingly, quality reporting and quality performance issues as well.