The Civil Division of the US Department of Justice (DOJ) recently issued a memorandum outlining unprecedented reforms aimed at accelerating the review and pursuit of certain qui tam complaints filed under the False Claims Act (FCA). Among other things, DOJ has announced that it will complete its review of new “benefits fraud” complaints — those alleging fraud against “federally funded, state-administered benefits programs” — within 120 days. Although the new policy seems based on unrealistic expectations, health care companies and providers should be prepared for a new normal in the pace of certain FCA investigations and an increase in litigation led by relators rather than the federal government. 

The Trump administration has stepped up its Medicaid fraud enforcement efforts, as demonstrated through a variety of agency actions taken over the past few months. The focus on Medicaid fraud undoubtedly will result in increased scrutiny of Medicaid providers and Medicaid managed care organizations (MCOs) by state and federal enforcement authorities.  

The Federal Bar Association’s 2026 Qui Tam Conference featured two sets of remarks from Deputy Assistant Attorney General of the U.S. Department of Justice’s (DOJ) Commercial Litigation Branch, Brenna Jenny (DAAG Jenny).  In her keynote address, DAAG Jenny offered insights into the current administration’s False Claims Act (FCA) enforcement philosophy and priorities. DAAG Jenny also addressed “Illegal DEI” FCA enforcement during a panel discussion and offered the Trump administration’s view of discrimination as a basis for potential FCA liability. Various other current and former DOJ officials offered insights on wide-ranging topics.  Below, we summarize the top 10 highlights from the Qui Tam Conference.

On January 22, 2026, the Department of Justice (DOJ or the Department) Criminal Fraud Section issued its 2025 Year in Review summary (YIR Summary). Our more detailed analysis of the full YIR Summary can be found here. DOJ’s Health Care Fraud Unit (the HCF Unit) is focused on “prosecuting complex health care fraud matters and cases involving the illegal prescription, distribution, and diversion of controlled substances.” To carry out its mission, in 2025, the HCF Unit operated 8 Health Care Fraud Strike Forces in 26 federal judicial districts across the nation. The HCF Unit’s reported average return on investment is $106.76 per $1 spent. 

Explore DOJ health care enforcement trends under Trump 2.0. Learn how leadership changes, new False Claims Act (FCA) priorities, and political initiatives like gender-affirming care investigations are reshaping compliance risks for 2026.

Explore how AI is reshaping health care enforcement in 2026. Learn about emerging state regulations, federal oversight, enforcement risks, and best practices for compliance in an evolving AI-driven landscape.

Learn the latest on EKRA enforcement and compensation rules for laboratory sales and marketing employees after the Ninth Circuit’s Schena decision. Explore DOJ’s stance, open compliance questions, and similar state law impacting clinical laboratories.

California legislative activity focused upon private equity (PE) group and hedge fund health care transactions has continued notwithstanding California Governor Gavin Newsom’s veto last fall of California Assembly Bill 3129 (AB-3129). As we discussed in previous posts here and here, AB-3129 would have authorized the California Attorney General (AG) to review certain PE group and hedge fund health care transactions, but Governor Newsom vetoed the bill based on his view that the California Office of Health Care Affordability (OHCA) rather than the AG should be assessing proposed health care transactions and their cost and market impacts.

On July 31, 2025, the United States Department of Justice (DOJ) announced a pair of settlements with companies accused of having violated the False Claims Act (FCA) by falsely representing their compliance with certain cybersecurity requirements applicable to federal contractors. These two settlements highlight key aspects of DOJ’s enforcement priorities: (1) DOJ’s strong focus on enforcing the FCA in the cybersecurity space, and (2) DOJ’s willingness to reward companies that self-disclose violations. All government contractors certifying compliance with regulatory and contractual requirements must stay vigilant and take the steps needed to comply. 

On July 11, 2025, the Ninth Circuit Court of Appeals affirmed the criminal conviction of laboratory operator Mark Schena for violations of the Eliminating Kickbacks in Recovery Act, 18 U.S.C. § 220 (EKRA) based on compensation paid to marketers who sold testing on behalf of Schena’s laboratory. 

A few elements of this decision are particularly significant, including the court’s finding that percentage-based compensation arrangements are not per se illegal under EKRA and that evidence of undue influence over providers’ decision-making must be presented to demonstrate that the compensation was paid to “induce a referral” in violation of the statute.  The decision is also notable for its reliance on case law interpreting the Anti-Kickback Statute to reach this conclusion.