Dive Brief:

• Healthcare fraud settlements under the False Claims Act totaled over $5.7 billion for the 2025 fiscal year ended Sept. 30, the highest amount ever and more than triple last year’s total, the Department of Justice said Friday.
• The FCA settlements fueled $6.8 billion in total judgments across industries, the highest amount in a single year.
• In healthcare, settlements involved federal programs like Medicare, Medicaid and Tricare, the program for active and retired service members and their families. The Justice Department said it also expanded its enforcement in cases involving managed care, prescription drugs and medically unnecessary care.

Dive Insight:

The False Claims Act imposes penalties on those who defraud U.S. government programs. Defendants found liable can be subject to treble damages — three times the government’s damages, plus a penalty that’s tied to inflation.

The FCA also allows private citizens, or whistleblowers, to file lawsuits on behalf of the government. Whistleblowers can receive a portion of settlements: In 2025, whistleblowers received over $262 million for successful healthcare fraud lawsuits, according to data from the DOJ.

Healthcare has historically made up a majority of settlements in the FCA as federal health spending grows. Still, settlements were outsized in 2025 compared to 2024, when healthcare judgments totaled $1.7 billion.

Several of the settlements announced involved instances of fraud that occurred over a decade ago....

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