DOJ and HHS Launch Joint False Claims Act Task Force, Announce New Enforcement Priorities

In a significant escalation of healthcare fraud enforcement, the U.S. Department of Justice and Department of Health and Human Services have established a joint working group focused on False Claims Act enforcement, signaling intensified scrutiny of healthcare and life sciences industries.

The collaborative task force, announced on July 2, represents a strategic pivot toward more proactive, data-driven investigations, particularly targeting high-expenditure areas like Medicare Advantage and pharmaceutical pricing. The initiative aims to streamline enforcement by evaluating the viability of novel legal theories early in investigations, ensuring they have necessary support from DOJ leadership before proceeding.

Brenna Jenny, DOJ Deputy Assistant Attorney General for the Civil Division’s Commercial Litigation Branch, will lead the working group alongside senior legal officials from HHS and its Office of Inspector General. Jenny previously helped establish a similar initiative during the first Trump administration, bringing valuable institutional knowledge to the effort.

While the DOJ continues to target traditional FCA violations such as kickbacks and upcoding, the working group significantly expands enforcement priorities. Key focus areas include Medicare Advantage operations, pricing practices for drugs, devices, and biologics (including discount arrangements, rebates, service fees, formulary placement, and price reporting), and barriers to patient care access, such as violations of network adequacy requirements.

The task force will also scrutinize kickback arrangements related to medical products paid for by federal healthcare programs, materially defective medical devices affecting patient safety, and manipulation of electronic health records systems designed to drive inappropriate utilization of Medicare-covered products and services.

In a marked departure from previous approaches, the working group will proactively analyze regulatory data collected by HHS to identify potential fraud patterns rather than relying solely on qui tam complaints from whistleblowers. This shift represents a more aggressive stance toward fraud detection, potentially increasing risk for non-compliant healthcare entities.

Healthcare providers face additional pressure as the group intends to consider whether HHS should suspend Medicare payments earlier in investigations when credible fraud allegations emerge, rather than waiting until investigations conclude. This approach may significantly impact providers’ defense strategies, as one element of materiality analysis for successful FCA claims involves whether the government has refused payment.

The formation of this specialized enforcement group contradicts earlier speculation that the current administration might prioritize FCA enforcement in areas such as trade and tariff violations rather than healthcare. Instead, it clearly signals that healthcare fraud will remain a central focus of DOJ enforcement activities.

For healthcare and life sciences companies, this development portends more aggressive FCA enforcement. Traditionally, new theories of FCA liability have emerged from relators or whistleblowers’ representatives, but this initiative suggests the DOJ itself will now develop innovative legal approaches to healthcare fraud cases.

With monthly meetings beginning in July, healthcare organizations should reassess compliance across all potential risk areas. Companies should prepare for heightened oversight and increasingly creative legal theories from federal enforcers. The combination of proactive data analysis and expanded enforcement priorities creates a more challenging regulatory environment for healthcare providers and life sciences companies.

The working group’s formation aligns with broader federal efforts to control healthcare spending and ensure program integrity across Medicare, Medicaid, and other federal healthcare programs. As healthcare represents a significant portion of federal expenditures, reducing fraud and abuse remains a bipartisan priority, despite changes in administration.

Market analysts suggest this enforcement initiative could have particular implications for rapidly growing sectors like Medicare Advantage, which has experienced substantial expansion in recent years and represents an increasingly significant portion of federal healthcare spending.