False Claims Act/Qui Tam Litigation

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The first half of 2026 has confirmed that False Claims Act (FCA) enforcement is not only continuing at historically elevated levels but is expanding in scope, sophistication, and institutional backing. With the Department of Justice (DOJ) reporting more than $6.8 billion in FCA settlements and judgments for fiscal year 2025 (the highest annual total on record) and qui tam filings on pace to set another record in FY 2026, federal fund recipients across various industries face a sustained period of heightened scrutiny. This mid-year update synthesizes the most significant developments and offers practical considerations for navigating the current enforcement landscape.

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We just released Episode 45 of the False Claims Act Insights podcast where Jody Rudman and I talk about this year’s big DOJ healthcare fraud takedown.

We talk about how this year’s takedown compares to those in prior years, and how Medicaid Fraud Control Units participated more than in the past. Jody also unpacks the…

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On June 4, 2026, The United States Court of Appeals for the Fourth Circuit issued a decision affirming the dismissal of a False Claims Act (FCA) suit for failure to meet Rule 9(b)’s pleading requirements—i.e., failing to state with “particularity the circumstances constituting fraud or mistake.” The decision marks an important victory for FCA defendants faced with vague or imprecise allegations of wrongdoing.

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On June 24, 2026, Acting Attorney General of the United States Todd Blanche along with other senior government officials and leaders announced “the greatest combined federal and state effort in combating healthcare fraud in history.” The 2026 National Health Care Fraud Takedown heralded 455 defendants charged across 56 federal districts and 45 states and territories, in connection with more than $6.5 billion in alleged false claims submitted to Medicare, Medicaid, and other federal health programs—all in a coordinated two-week window.

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We just released Episode 44 of the False Claims Act Insights podcast where Bryan Nowicki and I talk about this year’s much publicized string of egregious hospice fraud.

Bryan and I talk about how criminal fraud impacts the hospice industry as a whole, and has a particular collateral consequence on legitimate hospice providers and their…

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We just released Episode 43 of the False Claims Act Insights podcast where Sean Weiss of DoctorsManagement, LLC and I discuss the biggest topics in healthcare enforcement today. Sean predicts that technology is going to cause False Claims Act enforcement to rapidly improve, and he and I discuss ways healthcare providers can prepare themselves for…

On May 27, 2026, the Department of Justice (“DOJ”) announced that its Civil Division is implementing reforms to accelerate the review of False Claims Act (FCA) whistleblower complaints alleging fraud on federally funded, state-administered benefits programs. That same day, Assistant Attorney General of the Civil Division, Brett A. Shumate, issued an internal memorandum directing Fraud…

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We just released Episode 42 of the False Claims Act Insights podcast where Tim Ribelin and I discussed managed care FCA enforcement.

Tim recently discussed this topic at an American Conference Institute conference. Our listeners now get to hear Tim’s takes on “one way” or “add-only” chart reviews, and how aggressive documentation templates create FCA…

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The Department of Justice (DOJ) recently provided important information about how it plans to handle the surge in data-driven False Claims Act (FCA) qui tam lawsuits. On April 30, 2026, DOJ announced its Fraud Oversight through Careful Use of Statistics (FOCUS) Initiative, a new program designed to help the government assess viable data-driven qui tams. This initiative offers important insights into the DOJ’s evolving approach to these cases and potential new avenues for early dismissal.