DOJ National Fraud Enforcement Division. On August 13, 2026, the U.S. Department of Justice (“DOJ”) announced the enforcement priorities of its newly established National Fraud Enforcement Division (“Fraud Division”), signaling a significant expansion of federal fraud enforcement. The Fraud Division is expected to reach approximately 500 attorneys and staff by August 24, 2026, with additional growth planned over the next two years.
Health Care Identified as Enforcement Priority. With its mission being “to prosecute fraud in the United States, no matter its size or complexity,” the Fraud Division identified five principal enforcement priorities: (1) public trust and financial integrity; (2) health care; (3) internal revenue; (4) global trade and commerce; and (5) corporate misconduct.
Health care organizations should pay particular attention to this new enforcement framework, as the DOJ has identified health care fraud as a central priority and specifically highlighted fraud related to the following:
- Telemedicine,
- Medicare and Medicaid fraud,
- Controlled-substance diversion,
- Home health and hospice schemes, and
- Deceptive marketing of unsafe health care products and services.
When focusing on these priorities, the Fraud Division intends to break down data barriers and eliminate silos by working closely with U.S. Attorneys’ Offices, the Civil and Criminal Divisions, federal law enforcement, executive agencies, state and local partners. DOJ also plans to “supercharge” its Health Care Fraud Strike Force model through additional resources, enhanced data analytics, and technology. This enhanced capability could enable investigators to identify suspicious patterns proactively, rather than relying solely on traditional whistleblower complaints or referrals — a shift health care organizations should monitor closely.
Takeaways for Health Care Organizations. In light of DOJ’s increasingly proactive enforcement approach, health care providers that participate in Federal health care programs should prioritize their compliance monitoring activities and oversight of billing practices. Robust controls can help organizations support accurate reimbursement by identifying emerging concerns early and detecting billing patterns that may draw regulatory scrutiny. When potential compliance issues are identified, it is important to conduct timely internal investigations, implement appropriate remediation, and evaluate whether voluntary self-disclosure may be warranted. Taking these proactive steps can help strengthen the organization’s compliance posture and best position the organization in the current regulatory environment.
