The overwhelming majority of False Claims Act (FCA) cases are initiated not by the government but by individuals who file suit under the statute’s qui tam provisions. Nearly 1,300 qui tam suits were filed just last year. The Department of Justice (DOJ) has a statutory obligation to investigate the merits of every qui tam suit and has a bevy of enforcement tools to do so, including through issuance of civil investigative demands (CID) to defendants and witnesses. These investigations are notoriously long and burdensome on defendants. But recent guidance indicates a continued intent for DOJ to exercise closer scrutiny over investigations, to dismiss meritless cases, and—most recently—to make intervention decisions much more quickly.
Typical DOJ investigations and intervention decisions are measured in years, not months. On May 27, 2026, DOJ Civil Division issued a memorandum outlining significant reforms to accelerate the review of qui tam complaints filed under the FCA involving “benefits fraud”—fraud against federally funded, state-administered benefits programs, including Medicaid.
The memorandum establishes aggressive new timelines for DOJ’s review of these qui tam actions and signals an increased willingness to permit relators to take the lead in prosecuting cases. Despite the recent emphasis on prioritizing Medicare-related fraud, the exclusion of this significant area of FCA cases is notable and might suggest that DOJ is seeking to reserve more significant resources for more high-dollar fraud cases—like Medicare fraud cases. Or perhaps DOJ is using these benefits fraud investigations as a test case to assess its ability to fast-track merits determinations before expanding to a broader scope of FCA enforcement areas.
Accelerated Review of “Benefits Fraud” Qui Tams
The memorandum directs DOJ attorneys to prioritize and complete their review of new benefits fraud qui tam actions within the 60-day statutory period “to the maximum extent practicable,” and no later than 120 days. The FCA has long required intervention decisions within 60 days, but in practice, DOJ routinely obtained numerous six-month extensions to continue lengthy investigations. The memorandum references the March 2026 Establishing the Task Force to Eliminate Fraud Executive Order, which directed DOJ to take appropriate action to promote meritorious qui tams and ensure prompt review of these actions.
At the conclusion of this accelerated review, DOJ must either:
- Permit the relator to proceed with the action and assume primary responsibility for litigating it, subject to the government’s ongoing supervision and ultimate control.
- Conclude that the allegations warrant further government investigation.
- Determine that the qui tam should be dismissed under 31 U.S.C. § 3730(c)(2)(A) in line with the Granston Memo and Brenna Jenny’s public assurances of DOJ’s commitment to using this mechanism as appropriate.
If DOJ opts for further investigation, it has 120 days to:
- Develop an investigation plan.
- Schedule the prompt issuance of CIDs that include “targeted requests.”
- Schedule “early” witness interviews (and consider interviews and oral examinations “as possible alternatives” to document productions).
DOJ is also encouraged to request assistance from relators’ counsel and wait to assess the details of damages until after the investigation if those details would prolong the investigation period.
A typical DOJ FCA investigation—whether or not initiated based on a qui tam complaint—begins with a CID to the subject of the investigation. Initial CIDs can be incredibly broad as DOJ tries to learn about the company and its business, and compliance within expedited timeframes is nearly impossible.
Knowledgeable counsel can usually negotiate reasonable extensions and work with DOJ to prioritize important requests and make productions on a rolling basis. This typical CID response strategy may become unworkable under the new guidance and will hopefully lead to more narrowly crafted, targeted CIDs that prioritize what’s truly important to the investigation, which can be more reasonably addressed so that DOJ can meet these accelerated timeline expectations.
Though not expressly mentioned, given the rapid expansion of artificial intelligence (AI) tools, DOJ will almost certainly rely on AI and other advanced analytics to help keep up with the new expected pace of its investigations. At the ACI 13th Annual Advanced Forum on False Claims and Qui Tam Enforcement in January 2026, Brenna Jenny, deputy assistant attorney general for the Commercial Litigation Branch, pointedly noted during her remarks that “your next whistleblower could be your data.” Jenny highlighted the important role AI can and will play in assisting DOJ to analyze voluminous claims data and analyze patterns and trends that would previously have taken months.
Potential for Ongoing Extensions Remains
If further investigation is needed at the close of the 120-day investigation period, approval of an additional 120 days must be sought from the Deputy Assistant Attorney General of the Commercial Litigation Branch, and any additional extensions require approval from the Assistant Attorney General of the Civil Division. Whether these extensions will be freely granted (blunting the impact of these reforms) remains to be seen.
Whole-of-Government Approach
DOJ also boasts a “whole-of-government approach,” stating that new matters will be referred simultaneously to the Criminal Division and the National Fraud Enforcement Division for evaluation of potential criminal charges and to the affected agency for potential administrative action (to include payment suspension) while the civil investigation is ongoing. Strategically aligning responses to these different investigations will be key.
Continued Endorsement of Relator-Driven Qui Tams
The number of relator-driven qui tam suits has exploded in recent years. The memorandum even expressly acknowledges that this protocol “will increase the number of benefits fraud matters primarily litigated by relators.” This inevitable result and overall policy could be complicated depending on the outcome of United States ex rel. Zafirov v. Florida Medical Associates LLC, currently pending before the Eleventh Circuit.
In relator-driven cases, DOJ attorneys must communicate that the whistleblower and counsel will be expected to “shoulder the obligations of the litigation” and that the burdens and costs on the government should be minimized to the greatest extent possible.
The memorandum provides assurances that DOJ “nonetheless expects that its attorneys will continue to assume primary responsibility for investigating and pursuing the majority of incoming qui tam matters.” But DOJ’s intervention rates in health-care-related qui tam suits remains low. And if the Eleventh Circuit affirms the district court’s finding that the FCA’s qui tam provisions are unconstitutional under the Appointments Clause of Article III, we may quickly see updates to this framework.
Key Takeaways for Companies and Providers
Increased pressure in enforcement actions
The new review timeline means that companies that receive CIDs should ensure their compliance teams and outside counsel are prepared to respond promptly. The extended periods of rolling productions and extensive scope negotiation that companies have come to expect with DOJ may become more limited. But we may also see more focused and narrowly tailored requests rather than a boil-the-ocean approach. DOJ’s directive to file enforcement actions against defendants that fail to meet response deadlines represents a departure from typical practice and signals a more aggressive posture during the investigative phase.
Multifront exposure
The memorandum’s description of its “whole-of-government approach” means that a single qui tam complaint could trigger parallel civil, criminal, and administrative proceedings. Companies should consider the full spectrum of potential consequences when developing their response strategy.
Proactive compliance review
In light of the accelerated enforcement landscape, companies should review and strengthen their compliance programs, particularly their Medicaid billing practices.
If you have any questions, or would like additional information, please contact one of the attorneys on our White Collar, Government & Internal Investigations team or one of the attorneys on our Health Care team.
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