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Friday, July 18, 2025

DOJ and HHS Relaunch False Claims Act Working Group, Sharpen Healthcare Enforcement Priorities - White & Case LLP

On July 2, 2025, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) jointly announced the reestablishment of the DOJ-HHS False Claims Act (FCA) Working Group. While the two agencies have long collaborated on healthcare fraud enforcement, the formal relaunch of the Working Group signals a renewed and intensified focus on False Claims Act investigations, particularly in sectors where federal healthcare dollars and compliance risk intersect. In comments announcing the relaunch, Brenna Jenny, Deputy Assistant Attorney General for the DOJ Civil Division's Commercial Litigation Branch, explained the DOJ was "reinvigorating" the Working Group founded in 2020 to "formalize and enhance" collaboration between DOJ and HHS. The move builds on a series of recent DOJ enforcement initiatives, including the Civil Rights Fraud Initiative and expanded whistleblower incentive programs. It also aligns with the Trump Administration's broader agenda to "aggressively" enforce the FCA as a central tool in combating fraud against the federal government.

Key Enforcement Priorities

The Working Group outlined six enforcement priorities that will guide upcoming FCA investigations and referrals from HHS to DOJ:

  • Medicare Advantage: Including alleged risk score inflation, unsupported diagnoses and failures in data integrity and reporting.
  • Drug, Device and Biologics Pricing: Scrutinizing discounts, rebates, formulary placement fees and price reporting...


Read Full Story: https://news.google.com/rss/articles/CBMivwFBVV95cUxNcGJyR3hXS0h2VVVYZFp1NEdB...