(August 15, 2025) - Jenelle Beavers and Donald Lochabay Jr. of consulting firm Alvarez & Marsal discuss the recently announced False Claims Act Working Group under the departments of Justice and Health and Human Services, which focuses on prosecuting health care fraud.
The Department of Justice (DOJ) and the Department of Health and Human Services (HHS) recently announced the DOJ-HHS False Claims Act Working Group, created to continue the long-standing collaboration between the departments to detect and prosecute healthcare fraud using the False Claims Act (FCA).1, 2
The FCA provides that any person who submits a false claim to the government can be liable for three times the government's damages plus penalties for each claim submitted.3
The FCA Working Group, led by the Deputy Assistant Attorney General and lead counsel from HHS and HHS-OIG, includes leadership from the HHS Office of General Counsel, the Centers for Medicare & Medicaid Services Center for Program Integrity, the Office of Counsel to the HHS Office of Inspector General (HHS-OIG), and the DOJ Civil Division (represented by designees from U.S. Attorneys' Offices).
The group is expected to meet monthly. In the announcement, DOJ "encourage[d] whistleblowers to identify and report violations of the [FCA] involving priority enforcement areas."4
The DOJ announcement listed the following priority enforcement areas:5
•Medicare Advantage
•Drug, device, or biologics pricing, including arrangements for...
(August 15, 2025) - Jenelle Beavers and Donald Lochabay Jr. of consulting firm Alvarez & Marsal discuss the recently announced False Claims Act Working Group under the departments of Justice an...