As the Department of Justice (DOJ) has established its enforcement priorities over the last year, companies in regulated industries have worked to balance risk and react to the government’s areas of focus. Despite new federal leadership, one constant has remained: DOJ’s aggressive use of the False Claims Act (FCA) to crack down on perceived healthcare fraud.
The DOJ and qui tam relators have, year-over-year, used the FCA to target healthcare providers to combat alleged federal program fraud. With the DOJ announcing that FCA recoveries in fiscal year 2025 reached record highs of $6.8 billion total and $5.7 billion in the healthcare industry alone, all government contractors, but especially healthcare providers, must remain vigilant and committed to compliance with federal laws and regulations.
Staying ahead of the curve is essential to avoid costly settlements and reputational damage, as DOJ shows no signs of taking its foot off the gas.
The DOJ’s $6.8 billion recovery easily eclipsed the prior record of $5.3 billion set in 2024, demonstrating that civil fraud enforcement remains a top priority.
The FCA is the mechanism the DOJ uses to recoup funds that were fraudulently obtained from government programs. While the DOJ uses the FCA to recoup funds from government contractors in all areas, it primarily wields its power to combat healthcare fraud.
Indeed, Deputy Attorney General Todd Blanche referred to the FCA as “one of the government’s...
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