Jul 32025

DOJ Announces Reinvigorated False Claims Act Cooperation with the Department of Health and Human Services

Kristin Graham Koehler, Jaime L.M. Jones, Matt Bergs and Joseph R. LoCascio
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On July 2, 2025, the U.S. Department of Justice (“DOJ”) announced the renewal of the DOJ-HHS False Claims Act Working Group, a partnership with the U.S. Department of Health and Human Services (“HHS”) that aims to strengthen use of the FCA to combat healthcare fraud.  This is an initiative that was first announced during the first Trump administration, and follows the announcement of significant personnel changes at DOJ, as discussed here.

The Working Group will be jointly led by HHS’s General Counsel, the Chief Counsel to the HHS Office of Inspector General (“HHS-OIG”), and DOJ’s Deputy Assistant Attorney General of the Commercial Litigation Branch. The group’s membership will also include leadership from the Centers for Medicare and Medicaid Services Center for Program Integrity and designees from U.S. Attorneys’ Offices.

In addition to previously announced FCA enforcement priorities, including those that we previously discussed here, the Working Group will focus on:

  • Medicare Advantage;
  • Drug, device, and biologics pricing, including arrangements involving discounts, rebates, service fees, formulary placement, and price reporting;
  • Barriers to patient access, including violations of network adequacy requirements;
  • Kickbacks;
  • Materially defective medical devices; and
  • Manipulation of electronic health records to drive inappropriate Medicare utilization.

The Working Group intends to expedite ongoing investigations and to identify new leads by “leveraging HHS resources through enhanced data mining and assessment of HHS and HHS-OIG report findings.” The announcement also specifies that the Working Group will discuss when to implement payment suspensions and when to move to dismiss qui tam complaints under 31 U.S.C. section 3730(c)(2)(A), a topic that we have previously addressed here.

The announcement concludes by exhorting whistleblowers to identify and to report FCA violations.

 

This post is as of the posting date stated above. Sidley Austin LLP assumes no duty to update this post or post about any subsequent developments having a bearing on this post.

Kristin Graham Koehler

Washington, D.C.

kkoehler@sidley.com

Jaime L.M. Jones

Chicago

jaimejones@sidley.com

Matt Bergs

Chicago

mbergs@sidley.com

Joseph R. LoCascio

Chicago

joseph.locascio@sidley.com

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