DOJ Reports Record $6.8 Billion in False Claims Act Recoveries for Fiscal Year 2025

The U.S. Department of Justice announced on January 16, 2026, that it recovered $6.8 billion in settlements and judgments under the False Claims Act during fiscal year 2025, marking the highest single-year total in the law’s history. This milestone pushed total recoveries since 1986 beyond $85 billion.

Whistleblower activity played a crucial role in these recoveries, with a record 1,297 qui tam filings submitted in FY2025, significantly surpassing the previous year’s record of 980. These actions yielded more than $5.3 billion in settlements and judgments, with whistleblowers eligible to receive between 15% and 30% of recoveries depending on government participation.

The DOJ also reported opening 401 new investigations, increasingly leveraging data analytics to identify potential fraud cases.

Healthcare fraud remained the dominant source of FCA recoveries, accounting for $5.7 billion of the total. These recoveries addressed losses to federal programs and, in many cases, state Medicaid programs as well.

Medicare Advantage fraud has become a particularly significant focus for investigators. The program, which served 32.8 million enrollees in FY2024 and accounted for $462 billion in Medicare spending, has been described by the DOJ as an area of “critical importance” for combating fraud.

“With Medicare Advantage now representing the largest component of Medicare spending, ensuring the integrity of payment systems has become a top enforcement priority,” said a senior DOJ official speaking on background.

One notable case involved Seoul Medical Group Inc., which agreed to pay over $60 million to resolve allegations that they submitted false diagnosis codes for conditions patients didn’t have, artificially inflating Medicare Advantage payments. The DOJ also intervened in a qui tam action against national insurers and major brokers alleging kickbacks tied to plan steering.

Prescription drug fraud also remained a priority. In July 2025, HHS and DOJ jointly re-established the FCA Working Group, which identified drug pricing as a key enforcement area. The DOJ secured substantial recoveries related to drug pricing and kickbacks, including cases involving Medicare copay assistance, price-fixing, improper billing, and inflated drug pricing.

Providers billing for medically unnecessary services faced significant scrutiny as well. Vohra Wound Physicians Management LLC and its founder settled for $45 million to resolve allegations of overbilling and providing medically unnecessary wound care services. The government alleged that Vohra’s proprietary electronic medical record system was programmed to bill non-surgical procedures as surgical procedures.

Beyond healthcare, the DOJ reported robust FCA activity in government procurement, cybersecurity compliance, pandemic relief, and customs enforcement.

Military procurement cases featured prominently, including a $428 million resolution for alleged false cost and pricing data and double billing, which the DOJ described as its second-largest procurement fraud case.

The Civil Cyber Fraud Initiative, launched in 2021, continued to expand, recovering more than $52 million across nine cases. Civil cybersecurity fraud settlements have increased more than threefold in each of the past two years as the government prioritizes protecting sensitive information and critical systems.

Pandemic-related enforcement remained active, with more than 200 FCA settlements and judgments in FY2025 totaling over $230 million. Cumulative civil recoveries tied to alleged fraud in pandemic relief programs now exceed $820 million.

Trade and tariff enforcement has also intensified through the cross-agency Trade Fraud Task Force. The DOJ secured a $21.4 million settlement with Allied Stone, Inc. for allegedly misrepresenting goods imported from China to avoid antidumping duties, along with several other multi-million dollar settlements involving country-of-origin misrepresentations.

In a complementary announcement on January 22, 2026, the DOJ’s Criminal Fraud Division reported its own record year, highlighting sustained data-driven criminal enforcement in areas that overlap with FCA exposure. The Division emphasized its “innovative and proactive use of data analytics” and reported the largest healthcare fraud takedown in its history, involving alleged schemes with an intended loss exceeding $14.6 billion.

Looking ahead, the establishment of a Health Care Fraud Data Fusion Center will bring together DOJ, HHS-OIG, the FBI, and other agencies to “leverage cloud computing, artificial intelligence, and advanced analytics to identify healthcare fraud schemes through a whole-of-government approach.”

The DOJ also reaffirmed that entities may receive cooperation credit for timely self-disclosure, demonstrable cooperation, and effective remediation measures, noting that such actions have reduced penalties in several recent resolutions.