On July 2, 2025, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) announced the formation of a False Claims Act (FCA) enforcement working group. In her first public speech since rejoining the DOJ in May 2025, Deputy Assistant Attorney General Brenna Jenny of the Commercial Litigation Branch, DOJ Civil Division, discussed the working group in remarks at the American Health Law Association’s annual meeting.
Leadership and Membership
The cross-agency working group will include leadership from the HHS Office of General Counsel, the Centers for Medicare & Medicaid Services Center for Program Integrity, the Office of Counsel to the HHS Office of Inspector General (HHS-OIG), and the DOJ Civil Division (represented by designees from U.S. Attorneys’ Offices). Jenny, along with Acting General Counsel Sean Keveney of HHS and Acting Chief Counsel Susan Edwards of the HHS-OIG, are tapped to lead the group, which will meet monthly starting in July 2025.
Ongoing Collaboration Regarding FCA Enforcement
Past Administrations have formed similar cross-agency working groups to combat health care fraud through the False Claims Act. Jenny cofounded a similar FCA working group focused in part on COVID-related issues under the first Trump Administration. In the early 2000s, the Bush Administration oversaw a health care fraud enforcement working group including DOJ and HHS representatives, which led to numerous FCA investigations and prosecutions.
In its statement announcing the new group, HHS noted, “The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ) have a long history of partnering to use one of the government’s most effective and successful tools—the False Claims Act (FCA)—to combat healthcare fraud. This Administration is fully committed to supporting such work.”
Priority Areas
In her remarks, Jenny said that the working group will continue focusing on longstanding priority areas (including “Medicare Advantage and kickbacks”) but will also “identify areas of fraud, waste, and abuse that may have gone overlooked to date, such as violations of network adequacy requirements that serve as barriers to patient care.” The priority areas include:
- Medicare Advantage.
- Drug, device, or biologics pricing, including arrangements for discounts, rebates, service fees, and formulary placement and price reporting.
- Barriers to patient access to care, including violations of network adequacy requirements.
- Kickbacks related to drugs, medical devices, durable medical equipment, and other products paid for by federal health care programs.
- Materially defective medical devices that impact patient safety.
- Manipulation of electronic health records systems to drive inappropriate utilization of Medicare covered products and services.
Specific Coordination on Enforcement-Related Issues
The working group will target referrals by HHS to the DOJ of “potential violations of the FCA” involving priority areas and leverage HHS and HHS-OIG data to “expedite ongoing investigations.” The group is also tasked with considering whether, in certain cases, HHS should “implement a payment suspension” or whether the DOJ should intervene for the purpose of dismissal.
Jenny also noted that the group will analyze, at the “early” stages of an investigation, “whether novel legal theories are viable and supported by leadership” and “think[] creatively about areas of fraud, waste, and abuse that may have grown unchecked.”
Key Takeaways
There have been significant personnel and policy-related changes at the DOJ since the turn of the year, but this Administration—like others before it—has demonstrated that it will continue to focus on health care enforcement. Those efforts will include a renewed commitment to longstanding priorities like Medicare Advantage, violations of the Anti-Kickback Statute, and concerns about drug pricing.
The working group has signaled an interest in data-driven investigations and “creative[]” new theories that may result in novel enforcement actions going forward. During the AHLA annual meeting, government attendees noted that they will increasingly rely on artificial intelligence and advanced analytical tools to detect and investigate patterns that indicate fraud.
Both career staff and political appointees at the meeting emphasized a willingness to have an open dialogue with stakeholders and to consider concerns or questions from the public about enforcement strategies. But they also mentioned having limited time and resources, due to prioritization of major policies, focus on legal challenges relating to Executive Orders, and staffing shortages.
Given the changing landscape, particularly developing technology and the government’s reliance on it, health care organizations should continue to enhance and review compliance systems to minimize enforcement risk, especially in these priority areas.
If you have any questions, or would like additional information, please contact one of the attorneys on our Health Care Litigation team.
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