HHS and DOJ Announce False Claims Act Joint Working Group and Identify Enforcement Priorities
The U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) announced on July 2 their formation of a False Claims Act Working Group. The announcement and the formation of the Working Group reflect the Trump administration’s support of the activities of the DOJ and HHS in enforcing the False Claims Act and signaled that False Claims Act enforcement will be a major priority.[1]
The Working Group will include leadership from the HHS Office of General Counsel, the Centers for Medicare & Medicaid Services Center for Program Integrity, the Office of Counsel to the HHS Office of Inspector General, and the DOJ’s Civil Division, with designees representing U.S. Attorneys’ Offices.
The following six areas have been designated as priority enforcement areas:
- Medicare Advantage
- Drug, device or biologics pricing, including arrangements for discounts, rebates, service fees, and formulary placement and price reporting
- Barriers to patient access to care, including violations of network adequacy requirements
- Kickbacks related to drugs, medical devices, durable medical equipment, and other products paid for by federal healthcare programs
- Materially defective medical devices that impact patient safety
- Manipulation of Electronic Health Records systems to drive inappropriate utilization of Medicare covered products and services.
It is expected that cross-agency collaboration will significantly expedite investigations in these priority areas and identify new leads, and will do so by taking advantage of HHS’s enhanced data mining.
There will also be a focus on whether and when HHS should implement a payment suspension pursuant to 42 C.F.R. § 405.370 et seq. where credible allegations of fraud exist against a provider or supplier and on whether and when the DOJ should move to dismiss qui tam complaints.
The announcement includes a link to the June 11, 2025 memorandum from Assistant Attorney General Brett Shipmate to DOJ Civil Division Employees in which he details other FCA enforcement priorities.
[1] The Working Group is a revitalization of an HHS/DOJ work group that had been formed in December 2020 at the end of the first Trump administration in response to the Covid-19 crisis and the crisis-related supplemental funding under federal health care programs.
