Health care accounted for 84% of total recoveries.
The federal government recovered a record $6.8 billion through False Claims Act (FCA) cases in fiscal year 2025, with the health care sector accounting for $5.7 billion of that total, according to .
The figures represent the highest single-year recovery in the history of the False Claims Act, and health care’s share of the total (84%) marks a sharp increase from the prior year, when it made up roughly 60% of FCA recoveries. Whistleblower-initiated lawsuits also hit a record, with 1,297 qui tam actions filed during the fiscal year.
“The enforcement environment in 2026 is really more data-driven and pattern-focused than ever before,” Shannon Sumner, CPA, CHC, managing principal of PYA’s Nashville office and the firm’s chief compliance officer, Medical Economics. “Investigations are increasingly triggered by analytics, so practices get flagged because their data does not look like their peers.”
Among the most significant actions detailed in the report was the Department of Justice (DOJ)’s 2025 — the largest in U.S. history as measured by intended loss.
The operation charged 324 individuals, including 96 licensed medical professionals, across 50 federal districts, with the involvement of 12 state attorneys general. The intended loss totaled $14.6 billion. Federal authorities seized more than $245 million in cash, vehicles, cryptocurrency and other assets, while the Centers for...
Health care accounted for 84% of total recoveries. The federal government recovered a record $6.8 billion through False Claims Act (FCA) cases in fiscal year 2025, with the health care sector accou...