On July 2, 2025, the Ministry of Health and Social Services (HHS) and the Ministry of Justice (DOJ) announced the reinvigoration of their efforts to apply the law on false complaints (FCA) thanks to the formation of a joint working group FCA. The announcement reports has renewed federal attention to the application of fraud to health care as part of the extensive application strategies of the current administration within the framework of the FCA.
Working group program
Agencies have confirmed that the working group:
- Target traditional domains such as Medicare Advantage Fraud, bribes and practices for pricing drugs and devices.
- Develop yourself in less traditional areas that have recently attracted the application of the application of FCA, such as violations of the adequate network requirements, defective medical devices and the handling of electronic health file systems to stimulate the invoicing of Medicare.
- Focus on the priorities of the MJ civil application on the scale of the division announced in June 2025, which could further involve the emphasis on gender care.
Application approach
In accordance with these priorities, the working group will seek to maximize collaboration between cross agencies, to improve HHS’s reference mechanisms at the DOJ to develop new avenues proactively and take advantage of improved data exploration to identify the potential FCA violations. DoJ and HHS have also indicated that the group will examine when payment suspensions or tam The layoffs are appropriate, reflecting an effort to rationalize the FCA surveys and disputes.
Impact of industry
As with the other government -oriented industries subject to the priorities related to the FCA of the administration, the companies of the health space should expect an intensity of risk of civil application under the short -term FCA. At a minimum, the development of the FCA working group highlights the continuous importance for companies to maintain robust compliance systems, carefully monitor the provisions involving federal health care funds and remain ready to respond to government demands. Companies should anticipate closer federal coordination in the application of civilian and potential criminals concerning fraud and abuse in health care programs.
This message comes from Skadden, Arps, Slate, Meagher & Flom LLP. It is based on the company’s memorandum, “HHS and Doj Launch FCA Working Group with new joint priorities”, dated July 7, 2025, and available here.
