The Civil Division of the US Department of Justice (DOJ) recently issued a memorandum outlining unprecedented reforms aimed at accelerating the review and pursuit of certain qui tam complaints filed under the False Claims Act (FCA). Among other things, DOJ has announced that it will complete its review of new “benefits fraud” complaints — those alleging fraud against “federally funded, state-administered benefits programs” — within 120 days. Although the new policy seems based on unrealistic expectations, health care companies and providers should be prepared for a new normal in the pace of certain FCA investigations and an increase in litigation led by relators rather than the federal government.
While “benefits fraud” is not clearly defined, the new policy is aimed, at least in part, at Medicaid fraud. The memo references the recent Executive Order establishing the Task Force to Eliminate Fraud, which directed DOJ to “take appropriate action” to pursue meritorious qui tam complaints and to ensure prompt review of such actions. Since the release of the Executive Order, DOJ has ramped up its Medicaid fraud enforcement efforts, and the Civil Division’s memo presumably is a related development.
At the heart of DOJ’s reforms is a commitment to expedite and streamline the review of qui tam complaints involving benefits fraud. Within 60 to 120 days of the filing of a qui tam complaint, DOJ will: (1) permit the relator to proceed, subject to the government’s supervision and...
On May 27, 2026, the Department of Justice issued a memorandum announcing significant changes intended to accelerate investigations of alleged public benefits fraud. The memorandum requires pre-i...