DOJ Announces Accelerated Review of FCA Qui Tams Alleging Fraud Against State-Administered Benefits Programs
It is not business as usual at DOJ. In the latest announcement related to the Department’s efforts to fight alleged fraud, on May 27, 2026, Assistant Attorney General Brett Shumate issued a memorandum directing DOJ’s Civil Division and U.S. Attorneys’ Offices to accelerate the review of qui tams alleging fraud against federally funded state-administered benefits programs, including programs involving housing, food assistance, medical care, and cash assistance. The memorandum, titled “Accelerating Review and Enhancing Enforcement in Benefits Fraud Matters,” implements President Trump’s March 2026 Executive Order establishing the “Task Force to Eliminate Fraud,” which we reported on here, and which directed the Department to take appropriate action to promote “meritorious” qui tams and to complete investigations sooner, including within the 60-day statutory period.
DOJ and Texas AG Announce First Settlement in National Investigation of Gender-Affirming Care for Minors
On May 15, 2026, the U.S. Department of Justice and the Texas Attorney General announced the first publicly disclosed settlement arising from the federal government’s nationwide investigation into gender-affirming care for minors. The resolution with Texas Children’s Hospital reflects a coordinated federal-state enforcement approach grounded in False Claims Act (“FCA”) and Federal Food, Drug, and Cosmetic Act (“FDCA”) theories, alongside significant non-monetary remedies extending beyond traditional healthcare fraud settlements. In addition to a substantial monetary payment, the agreements impose operational, clinical, and governance-related obligations that may signal how enforcement authorities intend to pursue similar matters going forward.
This blog post examines the settlement terms, the broader federal policy and enforcement framework underlying the investigation, and the implications for healthcare providers and life sciences companies navigating areas of aligned federal and state enforcement focus. Click to read more about the resolution and what it may signal for future DOJ and state attorney general enforcement activity.
DOJ’s FOCUS Initiative: An Invitation or a Warning to Data Miner Relators?
On April 30, 2026, the Department of Justice’s Civil Division announced the Fraud Oversight through Careful Use of Statistics, or FOCUS, initiative. The initiative is aimed at a fast-growing category of False Claims Act relators that exploded in the aftermath of the pandemic and the Paycheck Protection Program: “data miners” who analyze publicly available government data to identify potential fraud and then file qui tam complaints. DOJ’s message to these non-traditional relators is twofold. First, the Department seems to have accepted that data-miner relators are here to stay, and so has invited sophisticated, well-supported data analysis that can help identify fraud that might otherwise go undetected. But second, DOJ intends to prioritize data-miner relators who can demonstrate meaningful pre-filing diligence, analytical rigor, familiarity with the governing program rules, and legally sufficient allegations.
For companies in sectors with substantial government funding or reimbursement, including healthcare, life sciences, defense, education, technology, and other government contractors, the practical takeaway is straightforward. Companies should evaluate their own publicly available data with the same skepticism and sophistication that a relator, short seller, or agency analyst might apply. Leveraging enhanced analytics and AI to match and front-run potential data miner-driven qui tams will allow companies to quickly assess the likely source of government interest, and explain it.
Clear and Present Danger: DOJ Trade Fraud and Anti-Corruption Priorities Signal Lasting Compliance Risk
This article, “Clear and Present Danger: How U.S. Department of Justice Trade-Fraud and Anti-Corruption Priorities Show Trade and Customs Risks Are Here to Stay,” published in The Global Trade Law Journal, examines the DOJ’s increased focus on trade fraud, tariff evasion and Foreign Corrupt Practices Act risks. The authors highlight key enforcement trends, including expanded whistleblower incentives and renewed use of the Trade Fraud Task Force, and explain how these developments are driving more aggressive investigations. The article also outlines practical steps companies can take to strengthen trade compliance, enhance oversight of third-party intermediaries and reduce enforcement risk.
New Guidance on U.S. Procurement Raises Risk to Federal Contractors From Potentially Discriminatory Practices
The Trump Administration is advancing a coordinated effort to tie federal funding and contracting eligibility more closely to its interpretation of antidiscrimination law. Recent Federal Acquisition Regulation (FAR) guidance directs agencies to incorporate a new contract clause prohibiting practices the Administration deems discriminatory, while proposed revisions to System for Award Management (SAM) certifications would require recipients of federal grants and other financial assistance to affirm compliance with similar standards. These developments build on earlier Department of Justice guidance outlining the types of conduct the Administration views as unlawful and are reinforced by a recent False Claims Act (FCA) settlement signaling a willingness to pursue enforcement in this area. Together, the FAR changes and proposed SAM revisions point to a more integrated enforcement framework—one that expands certification and disclosure obligations, links compliance more directly to FCA materiality, and increases oversight and reporting expectations. For federal contractors and grant recipients, the result is a heightened risk environment requiring careful reassessment of policies, internal controls, and subcontractor compliance in anticipation of greater scrutiny from both contracting agencies and enforcement authorities.
Drug Pricing and Medicaid Rebate Reporting: Enforcement Risk Remains
A recent analysis examines ongoing enforcement risks tied to drug pricing and Medicaid rebate reporting under the Medicaid Drug Rebate Program (MDRP), focusing on a federal court decision addressing how “strength” should be defined for products with the same concentration but different volumes. The court adopted a broader FDA-based definition and dismissed False Claims Act allegations, but the absence of clear statutory or regulatory guidance leaves room for continued scrutiny and potential shifts in agency interpretation. Read the full article for key takeaways on how courts may approach undefined MDRP terms, how FDA regulations can influence rebate reporting obligations, and practical steps manufacturers can take to mitigate False Claims Act risk through consistent, well documented compliance practices.
U.S. DOJ Issues Guidance on “Unlawful Discrimination” Related to DEI Programs for Recipients of Federal Funding
On July 30, 2025, the U.S. Department of Justice (DOJ) issued guidance on “unlawful discrimination” for recipients of federal funding and other entities subject to federal antidiscrimination laws, further underscoring Trump administration officials’ commitment to pursuing investigations and enforcement activity in this area.
U.S. DOJ Announces Renewal of FCA Working Group
On July 2, 2025, the U.S. Department of Justice (DOJ) announced the renewal of the DOJ-HHS False Claims Act Working Group (Working Group), a partnership with the U.S. Department of Health and Human Services (HHS) that aims to strengthen use of the False Claims Act (FCA) to combat healthcare fraud. (more…)
