February 3, 2026
By: Edgar Bueno & Matt Wilmot, HunterMaclean
On January 16, 2026, the Department of Justice (DOJ) published its annual report detailing an unprecedented amount of civil recoveries under the False Claims Act (FCA). In FY 2025, the DOJ recovered over $6.8 billion in FCA judgments and settlements, which is the largest recovery amount ever in a single year. This recovery more than doubled from the previous year of $3.1 billion and surpassed the previous record of $6.1 billion that DOJ recovered in 2014.
The FCA serves as one of the federal government’s most important fraud fighting tools in recovering monies improperly paid out. The announcement is particularly noteworthy, as it underscores the DOJ’s intention to aggressively use the FCA and, in novel ways, to advance the administration’s “America First” policy objectives. It also coincides with the creation of the new National Fraud Enforcement Division within the DOJ, which will centralize resources and coordinate the administration’s approach to fraud enforcement.
FCA Enforcement Highlights
Not only did the amount of recoveries increase in 2025, but the number of FCA cases filed also increased. There was a record number of 1,297 new qui tam cases (up from 980 in 2024) filed by whistleblowers. This increased number of whistleblower filings continues a trend seen over the past several years.
At the same time, the DOJ initiated over 400 new FCA matters on its own. This marks a record for these types of affirmative FCA actions by DOJ which have increased through use of AI and data mining to identify billing outliers who are more likely to be defrauding the federal government.
In addition, we saw the DOJ increase and aggressively use civil investigative demands (CIDs), which are powerful investigative tools authorized under the False Claims Act. CIDs are used by DOJ attorneys to obtain documents and testimony during the investigative stage of an FCA matter. The rise in both qui tam actions and affirmative matters is a clear indication that the pipeline of FCA investigations remains strong.
Health Care Remains the Enforcement Priority
Health care continues to take center stage of FCA enforcement efforts. Over $5.7 billion of the 2025 recoveries involved the health care industry specifically in the areas of Medicare Advantage, prescription drugs, and medically unnecessary items and services.
In one litigated case, over $1.6 billion in FCA damages and penalties were assessed against Janssen Products relating to its improper marketing of HIV drugs that led to the submission of false claims for reimbursement from the federal health care programs. In a case involving the Medicare Part C program, the government obtained a $98 million settlement from a Medicare Advantage organization that allegedly submitted thousands of claims containing unsupported and invalid diagnosis codes in order to increase its payments.
The DOJ also continued its aggressive pursuit of illegal kickbacks paid to health care providers to induce them to become high-volume prescribers of certain drugs. For example, Gilead Sciences agreed to pay $176 million for having offered and paid kickbacks in the form of honoraria payments, meals, and travel expenses to practitioners who participated in the company’s speaker program. The DOJ’s persistent focus on kickbacks is notable, as there has been much litigation, and not always in DOJ’s favor, about the precise legal standard for FCA liability for kickback conduct.
Medically unnecessary wound care was at the center of a $45 million FCA settlement against Vohra Wound Physicians Management and its physician owner. This enforcement trend is likely to continue, as we are monitoring several ongoing investigations involving the wound care industry and the billing of skin substitutes in excessive amounts.
Expected Enforcement for 2026
In addition to health care fraud, the DOJ has noted other key enforcement areas:
- Government Procurement and Defense Contracting Fraud involving kickbacks, improper pricing, and non-conforming goods and services;
- Cybersecurity Fraud involving breaches, false certifications, and noncompliance by government contractors;
- Pandemic-Related Fraud involving federal relief money that was inappropriately claimed and distributed; and
- Trade Fraud involving schemes to avoid paying tariffs and custom duties.
FCA enforcement is expected to increase in 2026 and even affect organizations and entities that typically have not served as a focus. For example, the administration has already implemented a process to use the FCA to combat discriminatory practices and policies related to antisemitism and diversity, equity, and inclusion (DEI) programs. The DOJ has also sought to use the FCA to stop false or fraudulent records from being used in immigration matters, and to prevent health care practitioners from providing gender affirming care. It remains to be seen whether the scope of the FCA can reach such activities.
The administration’s reliance and focus on the FCA makes the several pending constitutional challenges to the FCA even more interesting to follow. The Eleventh Circuit Court of Appeals recently heard oral arguments in United States ex rel. Zafirov v. Florida Medical Associates challenging a district court’s ruling that the FCA’s qui tam provisions violate the Appointments Clause of Article II of the Constitution. The Supreme Court may eventually have to decide the issue as three justices have already indicated some agreement that the qui tam provisions could be unconstitutional.
Another development that may impact FCA enforcement is the number of Assistant United States Attorneys that have recently left the DOJ. These departures necessarily include civil attorneys whose primary focus was to prosecute FCA cases. Unless these positions are filled, fewer attorneys will be available to handle FCA matters, especially if other DOJ priorities, like immigration enforcement, demand attention. Cases may then move more slowly and take longer than expected to proceed. Furthermore, with newer, and possibly less experienced AUSAs handling FCA matters, we could start to see new and unconventional approaches to investigating, resolving, or litigating an FCA case.
All of these developments will certainly make for an interesting year of FCA enforcement. We will continue to monitor these important developments.
For more information about False Claims Act compliance, investigations, or enforcement trends, please contact the HunterMaclean Government Investigations & White-Collar Defense team.
