False Claims Act Enforcement in Year 2 of Trump 2: What Healthcare Entities Need to Know Now

The False Claims Act has long been the government’s workhorse for civil healthcare fraud enforcement. But the Trump Administration has put it to work in new pastures — and a panel today at the American Health Law Association took stock of both tracks: the novel policy-driven initiatives reshaping the FCA landscape and the traditional enforcement priorities that remain central.

Two Tracks, One Statute

The administration has used the FCA to advance policy goals outside its traditional terrain. DEI programs, gender-affirming care, trade and customs fraud, and immigration compliance have all become enforcement priorities. Meanwhile, conventional healthcare fraud enforcement is setting records: FY 2025 saw 1,297 qui tam filings — an all-time high, up 82 % from FY 2023 — and $5.34 billion in total recoveries. The upshot is that healthcare entities face two distinct sets of demands on their compliance programs at once.

The Policy-Driven Track

The administration’s Civil Rights Fraud Initiative, launched in May 2025, targets entities that certify compliance with federal civil rights laws while maintaining what DOJ characterizes as discriminatory DEI practices.

Gender-affirming care is a separate and rapidly evolving enforcement front. DOJ has issued more than twenty administrative subpoenas to providers, but every court to consider a challenge has ruled for the providers. The Department has since shifted to grand jury subpoenas, which have also drawn court challenges. Given the constantly shifting terrain, healthcare providers should track developments closely.

The Traditional Track Remains Active

On the traditional side, the DOJ-HHS FCA Working Group, announced in July 2025, has identified four priority areas: Medicare Advantage coding, anti-kickback arrangements, drug and device pricing, and network adequacy. The new DOJ-HHS-FBI Data Fusion Center and the April 2026 FOCUS data-mining initiative signal that data-driven investigation — including by outside relators who mine public government data — will increasingly drive enforcement. Skin substitute billing is another active area, with Medicare Part B spending growing 20-fold between 2019 and 2024.

The Takeaway for Healthcare Entities

The breadth and velocity of current FCA enforcement make proactive compliance investment essential. The whistleblower ecosystem is expanding on all sides — traditional insider relators, data miners, and new programs are all driving more filings. And DOJ’s cooperation and self-disclosure framework offers meaningful credit to entities that get ahead of problems.

If you have questions about navigating this enforcement environment, reach out to any member of our team.

© Arnold & Porter Kaye Scholer LLP 2026 All Rights Reserved. This Blog post is intended to be a general summary of the law and does not constitute legal advice. You should consult with counsel to determine applicable legal requirements in a specific fact situation.