False Claims Act Mock Trial Institute Reveals Shifting Landscape in Healthcare Fraud Litigation

The American Bar Association’s 2026 False Claims Act Mock Trial Institute concluded recently in New Orleans, drawing record attendance and providing critical insights into the evolving dynamics of healthcare fraud litigation. The sold-out event offered legal professionals from government, relator, and defense practices a rare opportunity to network outside the typically adversarial atmosphere of courtroom proceedings.

Industry observers noted that federal resources for investigating and litigating traditional False Claims Act (FCA) cases in healthcare and government contracting have diminished noticeably. This reduction stems from decreased personnel at both Main Justice and U.S. Attorney Offices, coupled with the current administration’s focus on non-traditional FCA issues including diversity, equity, and inclusion initiatives and gender-affirming care.

This federal pullback has created a power vacuum that state attorneys general are increasingly filling. Sara Vann and Candice Deisher from the Georgia and Virginia Attorneys General Offices respectively delivered what many attendees described as a “masterclass” on the National Association of Medicaid Fraud Control Units (NAMFCU) and state AG operations during a dedicated roundtable session.

“We’re witnessing an unprecedented shift toward state-level enforcement,” remarked one panelist during the “FCA’s Role in the American Justice System” discussion, which featured a former U.S. Attorney, the most recent Deputy Assistant Attorney General from the Civil Division, and the President and CEO of The Anti-Fraud Coalition. State representation at this year’s Institute reached an all-time high, with over a dozen attendees plus faculty members from various state AG offices.

The centerpiece of the Institute—a mock jury deliberation livestreamed to attendees—delivered unexpected results that challenged conventional wisdom about FCA cases. The mock trial centered on a “worthless services” case involving a nursing home allegedly failing to provide adequate care while still submitting claims for per diem payments.

Despite most faculty and attendees predicting a swift verdict favoring the government and relator, the jury deliberations revealed significant complexities. Multiple jurors struggled with the causation element—specifically, establishing a clear connection between the alleged lack of care and the submission of false claims.

“Some jurors questioned how nursing staff would know a lack of care would result in false billing, especially since there was no allegation that the patient care records themselves were falsified,” noted one observer. Others wondered how the billing department would have known care wasn’t properly provided.

The “knowledge” requirement of the FCA similarly proved challenging, with a majority of jurors finding insufficient evidence that claims were submitted with knowledge of their falsity. Several jurors also expressed skepticism about the relator—a former director of nursing—questioning both his three-year delay in reporting the alleged violations and his financial motivation in pursuing the case.

Legal experts present at the Institute emphasized that these jury dynamics reflect a broader reality in FCA litigation: cases that seem straightforward to practitioners often present significant hurdles when evaluated by citizens unfamiliar with healthcare billing systems or government contracting.

“What was perhaps most reassuring,” one attendee noted, “was watching the jurors approach their task with genuine seriousness and sense of duty. They took their time and deliberately examined each element required for an FCA claim.”

The Institute was hosted by the U.S. District Court for the Eastern District of Louisiana, with proceedings held in Judge Papillion’s courtroom. Judge Susie Morgan not only facilitated the use of the courthouse but also presided over the entire mock trial.

As FCA litigation continues to evolve, practitioners across the spectrum are adjusting their strategies to account for increased state involvement and the complex causation challenges revealed through this year’s Institute—challenges likely to shape the landscape of healthcare fraud litigation in the coming years.