Vice President and CMS Announce Suite of New Administrative Actions to Further Federal Anti-Fraud Health Care Initiatives
Last week, the White House and CMS announced a set of new administrative actions to further the Administration’s anti-fraud mission, including in particular CMS’s CRUSH (Comprehensive Regulations to Uncover Suspicious Healthcare) initiative, announced earlier this year. At a May 13, 2026 press conference, Vice President J.D. Vance, CMS Administrator Dr. Mehmet Oz, and CMS Deputy Administrator and Chief Operating Officer Kim Brandt outlined measures designed not only to identify and prevent fraud, but also to pressure states and their Medicaid Fraud Control Units (“MFCUs”) to take a more active enforcement role.
DOJ’s National Fraud Enforcement Division Launches West Coast Health Care Fraud Strike Force
In a further sign that healthcare fraud enforcement remains a top Department of Justice (“DOJ”) priority, on April 30, 2026, the National Fraud Enforcement Division ( “Fraud Division”) announced the launch of the West Coast Health Care Fraud Strike Force (“West Coast Strike Force”). While the Fraud Division was itself newly created, this latest news is of a piece with the traditional model and enforcement approach of DOJ’s dedicated health care fraud team going back to 2007. Nationally, since its inception, the HCF Strike Force program has been responsible for the prosecution of over 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion.
E.D. Pa. Rejects Indefinite Sealing of FCA Extension Materials, Emphasizing Narrow Purpose of Seal
A recent decision from the Eastern District of Pennsylvania provides an important procedural win for defendants and a reminder that the False Claims Act’s seal provision is not intended to provide indefinite confidentiality. In United States ex rel. Compton v. HCR ManorCare, Inc., the court ordered the unsealing of close to 50 ex parte motions that the United States filed to extend the statutory 60-day seal period to close to ten years, while it investigated the complaints and decided whether to intervene.
DOJ Announces FOCUS Initiative to Work with Data Miners Filing Qui Tams
As we previously reported here, record numbers of cases are being filed by “whistleblowers” under the FCA—approximately 1,300 qui tam suits last year alone. This morning, Brenna Jenny, the Deputy Assistant Attorney General, Civil Division, Commercial Litigation Branch, announced at a conference that much of the surge in qui tam complaints is being driven not by insiders, but by entities set up to mine publicly available government data sets. That is putting pressure on DOJ’s Civil Fraud Section, tasked with investigating qui tam allegations. In order to address the challenge, Jenny announced the Fraud Oversight through Careful Use of Statistics (FOCUS) initiative, which presents an opportunity for data miners to meet with the Civil Fraud Section to explain the reliability of their data. Though not a pre-filing requirement, data miners who choose to participate “should be prepared to explain what differentiates their approach, how they validate their findings, and why their methodology provides a reliable basis for identifying high-quality, actionable False Claims Act matters.” DOJ’s announcement of the FOCUS initiative makes clear that “the Department will prioritize working with data miners that have demonstrated an investment in pre-filing diligence and commitment to analytical rigor, familiarity with program rules, and legally sufficient allegations.” It will be interesting to see whether the Department increases its exercise of authority to dismiss qui tam suits brought by data miners that cannot so demonstrate.
DOJ Announces First FCA Settlement Resolving Title VII Discrimination Allegations
Last week, the Department of Justice (“DOJ”) announced a more than $17 million settlement with IBM to resolve allegations that the company violated the FCA by defying “anti-discrimination requirements as set forth in Title VII.” This is the first settlement to emerge from the DOJ’s Civil Rights Fraud Initiative, on which we previously reported here and here. Unveiled May 19, 2025, the Initiative aims to use the FCA to pursue claims against federal funding recipients that allegedly violate civil rights laws via “racist preferences, mandates . . . and activities”—including where those violations occurred in the context of companies operating diversity, equity, and inclusion programs. Notably, as we reported here, the Deputy Assistant Attorney General of DOJ’s Commercial Litigation Branch, Brenna Jenny, used an address at the Federal Bar Association’s Qui Tam Conference last February to stress DOJ’s commitment to enforcement premised on such discrimination.
TX AG’s Office Continues Aggressive Enforcement Against Healthcare Entities Operating in Texas
In just the last week, the Texas Attorney General’s Office (“TX AG’s Office”) filed three actions against healthcare providers and entities, continuing an increasingly robust and aggressive enforcement regime that dates back to at least the beginning of 2025.
DAAG Brenna Jenny Warns Heightened FCA Enforcement Is “The New Normal,” Addresses Enforcement Priorities and Policies
During her keynote speech at the Federal Bar Association’s Qui Tam Conference, Brenna Jenny, Deputy Assistant Attorney General for the Commercial Litigation Branch, stated that robust FCA enforcement is “the new normal.” Key statistics, including those we discussed here, back her up: she revealed that DOJ has issued more than 1,000 Civil Investigative Demands (“CIDs”) in each of the last four years, noted that qui tam actions increased by 33% last year, and that 480 qui tam actions have already been filed so far in fiscal year 2026. She attributed this dramatic increase at least in part to enhanced data mining being conducted by DOJ and whistleblowers. Describing the FCA as a “flexible tool,” Jenny left no doubt that FCA enforcement will remain high even as she acknowledged that it is not “an all-purpose anti-fraud statute.”
DAAG Jenny Reinforces Commitment to FCA Enforcement Premised on Discrimination
At the Federal Bar Association’s Qui Tam Conference, Brenna Jenny, the Deputy Assistant Attorney General of DOJ’s Commercial Litigation Branch, offered the most detailed description yet of the Trump Administration’s effort to employ the FCA to combat practices that violate federal antidiscrimination laws, as we have previously reported here, here, and here. Jenny noted that while promoting diversity is not itself unlawful, it is also “not a protective talisman.” She stated that she believed some companies had “lost their way” in the pursuit of DEI and engaged in unlawful discrimination by pressuring their employees to make hiring and promotion decisions based on race or sex.
DOJ’s New FCA Settlements Underscore Trump Administration’s Focus on Tariff and Customs Compliance
Two recent settlements involving imports from the People’s Republic of China (“PRC”) illustrate the U.S. Department of Justice’s (“DOJ”) commitment to rapidly stepping up enforcement against tariff evasion and customs fraud through the False Claims Act (“FCA”). As we covered here, tariffs have been central to the administration’s trade strategy, and DOJ’s growing use of the FCA as an enforcement tool in this space is expected to drive a significant rise in both whistleblower allegations and recoveries.
DOJ Announces Reinvigorated False Claims Act Cooperation with the Department of Health and Human Services
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.