2026 False Claims Act Statistical Year in Review | Mintz 2026 False Claims Act Statistical Year in Review

False Claims Act Statistical Year in Review

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In our annual report, we examine health care enforcement trends, predict how health care enforcement may evolve, and offer practical guidance about what these trends and predictions mean for health care providers, payors, and other stakeholders.

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Recoveries Approach $7 Billion, with Health Care Cases Leading the Way

Health Care Enforcement Trends & Analysis

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Mintz’s Health Care Enforcement Defense practice group reports on qui tam FCA cases, other government enforcement actions, and significant regulatory developments from the past year.

Health Care Enforcement Trends & Analysis

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Health Care Enforcement Trends & Analysis

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New Cases in 2025 Soar Past 2024’s Record Highs

The Old Normal (FY 2024-2024) Qui tam volume surges, DOJ volume is stagnant.

Health care cases contributed significantly to the year-over-year growth in FCA cases. After three years of stagnant health care case volume, total new health care cases in FY 2025 rose by 40%. Both qui tam and government-initiated cases contributed to the growth in health care cases, with qui tam volume growing by 24% and government-initiated health care case volume increasing by an astounding 110%.

A four-year surge in False Claims Act (FCA) case activity roared on unabated during the federal fiscal year (FY) that ended September 30, 2025. As the Department of Justice (DOJ) reported in its annual statistical report, 1,698 new FCA cases were initiated in FY 2025. This number exceeds by 21% the previously record-setting number of FCA cases recorded in FY 2024 (1,405).

inspectors general — fell slightly from FY 2024 (425). The primary driver of the overall growth in FCA cases was a 32% increase in qui tam cases filed under the FCA’s whistleblower provisions (up from 980 in FY 2024 to 1,297 in FY 2025). The net result is that total FCA case volume has grown 110% since FY 2021, more than doubling the level of new cases seen at the height of the COVID-19 pandemic.

The volume of FCA cases not related to the Department of Defense (DOD) or the Department of Health and Human Services (HHS) continued to grow in FY 2025, likely driven by a burgeoning number of cases arising from Paycheck Protection Program (PPP) fraud. In fact, these cases represent the largest percentage of all newly filed FCA cases (991 of 1,698 cases filed in FY 2025).

DOJ recovered $6.89 billion in FCA settlements and judgments in 2025, which is the highest annual recovery total since DOJ started reporting FCA data in 1987. Of that amount, a staggering $5.72 billion — 83% of the total — was recovered in health care cases. As these recovery amounts demonstrate, even as non–health care FCA cases proliferate, health care cases yield by far the most significant returns to the government.

The reasons for the decrease in new government cases since FY 2023 are unclear, but could suggest that qui tam enforcement has long been — and will remain — the central means by which FCA cases are initiated. The government enforcement surge shown above for FY 2018 to FY 2023 began during the first Trump administration. It seems unlikely that declining government cases in FY 2025 resulted from a policy choice to deemphasize enforcement. To the contrary, the DOJ press release announcing the release of the FY 2025 statistics reiterates the government’s objective to “continue to aggressively deploy [the FCA] to protect taxpayer dollars and hold all fraudsters accountable.”

Record-setting FCA case volume in FY 2025 is explained in part by surging qui tam case volume offsetting the decline in government-initiated FCA cases. Between 2018 and 2023, an apparent “New Normal” emerged. The volume of government-filed cases grew almost fourfold, from 133 cases in FY 2018 to 506 cases in FY 2023 following almost 25 years of stagnant government case activity. At the same time, qui tam activity appeared to plateau, suggesting that there might come a new equilibrium for FCA enforcement between DOJ-initiated cases and qui tam whistleblower cases.

However, the case commencement trend lines for FY 2024 and FY 2025 tell a different story, suggesting that we are returning to the “Old Normal,” as government filings declined in the face of rapid increases in qui tam cases. In fact, the surge in qui tam filings in FY 2025 resulted in total case volume growing 21% over FY 2024.

One possible reason that government case volume decreased over the last two years could be an ongoing loss of staff within DOJ. According to a November article published by the American Bar Association, some 5,500 DOJ employees (not all of whom were lawyers) have quit or been ousted since the beginning of the second Trump administration. Given that there are about 10,000 lawyers in all of DOJ, the loss of that many staffers — whether attorneys or non-attorneys — undoubtedly put a significant strain on those who remain.

If the trends for FY 2024 and 2025 continue, they may demonstrate that recent high levels of government activity were an abberation, and that heavy reliance on whistleblowers for FCA enforcement will continue to be the norm. At the same time, as discussed in our EnforceMintz analysis of constitutional issues in FCA litigation, the qui tam enforcement paradigm is under fire.

In the Zafirov case currently pending before the Eleventh Circuit, the trial court held that whistleblower litigation of a declined case violated Article II of the Constitution.The trial court’s decision rests on a unitary executive interpretation of Article II that the current administration champions. Nonetheless, DOJ is defending the qui tam provisions as an important enforcement mechanism. The resulting tension between overall Trump administration policy and its position on qui tam enforcement of the FCA has led DOJ to defend the case on narrow grounds. Were Zafirov to reach the Supreme Court and yield a decision affirming the trial court’s dismissal of the case, the resulting precedent would have a profound impact on the statistical categories reported by DOJ.

Qui tam cases unrelated to health care and defense spending are driving new case volume. Ironically, even as defendants levy Article II challenges against whistleblower cases, new qui tam filings are growing at rates not seen in 15 years. With the FY 2025 cases remaining largely under seal, it is not possible to predict the precise types of claims and defendants that make up those new cases. What we can say is that for the third year in a row cases not involving the DOD or HHS are the majority of new case filings, as shown in the following chart.

Prior to 2025, this trend apparently was driven by aggressive enforcement directed toward fraudulent claims for COVID-19 pandemic relief, but other cases may now be playing a role. According to this year’s DOJ press release, enforcement activity in FY 2025 included “combating fraud in ... the government’s procurement, loan, and grant programs and redressing the improper avoidance of tariffs and customs duties that are owed.” These targets would include PPP fraud as well as cases prompted by other government policies.

The DOJ press release further indicates that the government-initiated cases include investigations addressing current administration enforcement priorities, including supposed fraud arising from diversity, equity, and inclusion (DEI) activities of government contractors and grant recipients, claimed antisemitic activities by government program participants, and provision of gender-affirming care by providers participating in federal health care programs. (Our EnforceMintz article “Health Care Enforcement Under Trump 2.0: Leadership Shakeups and Shifting Priorities” covers DOJ’s health care enforcement priorities and related changes in 2025.)

Health care case activity in FY 2025 as compared to FY 2024 saw noteworthy growth in two respects. First, health care qui tam filings grew at rates comparable to the robust overall growth in qui tam cases: health care qui tam filings increased by 24% in 2025, while total qui tam filings increased by 32%. Second, despite a total decline in new government-initiated FCA cases (down 6% from FY 2024), the number of government-initiated health care cases substantially increased in FY 2025 (up 110% from FY 2025). The health care case trend since 2018 looks like this:

Health care cases remain a significant focus of federal enforcement activities and generate the vast majority of federal recoveries. While non-DOD and non-HHS cases comprised the majority of new FCA cases in FY 2025, health care cases continue to make up a substantial share of total case volume (641 out of 1,698 new FCA cases filed in FY 2025 were health care cases).

Significant findings from Mintz’s Health Care Qui Tam Database. Mintz tracks unsealed health care cases to evaluate trends in cases that are unsealed. Unlike the DOJ data, the unsealed dockets and filings allow visibility into the substance of the claims being made, who is bringing the claims, and who is being sued. We describe key findings below.

health care enforcement defense chair

The steep increase in government health care cases (up 110% from FY 2024) in the face of an overall decline in government enforcement activity is particularly significant. This fact suggests that notwithstanding staffing challenges and competing non–health care enforcement priorities, the government remains committed to investigating health care fraud.

A likely reason for DOJ continuing to allocate investigative resources to health care cases is the potential financial payoff. Just as notorious bank robber Willie Sutton supposedly claimed that the reason he robbed banks was “because that’s where the money is,” there can be no doubt that the high dollar returns on health care FCA cases encourage ongoing government and qui tam focus on that sector. The following chart shows the amounts that DOJ and qui tam related recoveries contributed to overall FCA recoveries over the past 15 years:

In 14 of 15 years — 2014 being the sole exception — health care recoveries dwarfed all other FCA recoveries. The bulk of those dollars were recovered in health care qui tam cases, which brought in 43% of all recoveries in that 15-year period. Over that time, aggregate health care recoveries totaled over $33.1 billion, an amount equal to 57% of all FCA recoveries from FY 2011 through FY 2025. The value of these recoveries provides a significant incentive for the government to focus on health care cases and explains why DOJ is defending the FCA qui tam provisions against Article II arguments that it otherwise might be inclined to support.

This chart also shows the astounding recoveries obtained in FY 2025. FCA recoveries approached the record $6.89 billion in only two of the past 15 years (and never in any year before 2011). It also shows again the importance of health care recoveries — and, in particular, health care qui tam recoveries — to the public fisc. Fully 65% of total FY 2025 recoveries came from health care qui tam cases. When government cases are included, total health care recoveries made up 83% of all FCA recoveries in FY 2025. (In its FY 2025 FCA Fact Sheet on False Claims Acts Settlements and Judgments, DOJ details some of the settlements that drove this number.) Thus, despite declining as a percentage of the number of new cases instituted, health care cases continue, by a wide margin, to be financially the most significant FCA cases.

The most-targeted defendants have evolved in recent years. Cases unsealed in 2025 targeted a broad variety of defendant types, representing the diversity of the health care sector.

Government intervention rates in 2025 remained consistent with prior years. The decline in government-initiated cases seen in the DOJ data has not translated into declining intervention rates. Here is what we found as to intervention in unsealed health care cases in calendar year 2025:

Outpatient clinics, physicians and dentists, and pharmacies were the most frequent defendant types, accounting for 43% of all defendants sued and representing a notable increase in cases filed against these defendant types over recent years past. Hospitals, insurers, clinical laboratories, DME and medical device companies, and management companies were all sued at comparable rates. The growing number of claims targeting elderly and end-of-life care — including skilled nursing facilities, home health care, and hospice — appears to have leveled off after seeing significant growth in prior years.

Because cases unsealed in 2025 were often filed five and even 10 years earlier, these figures do not reflect the current focus of government investigators and qui tam counsel. We would expect the current focus on managed care companies, particularly around risk adjustment and denial of service claims, to show up in increased numbers of insurance and health plan cases being unsealed over the next few years.

Who is bringing cases? Even though the FCA does not require direct insider knowledge of a potential false claim to bring a qui tam action, insider knowledge continues to drive whistleblower actions under the FCA. In calendar year 2025, the breakdown of relator types in unsealed health care cases was as follows:

As is typical in most years, over one-half of all qui tam plaintiffs were former employees of a defendant, and three-quarters of whistleblowers were either current or former employees. Employees generally have deep knowledge of conduct supporting FCA allegations. Former employees, who often have separated from the defendant on bad terms, frequently have both knowledge and an axe to grind. It can make for a deadly combination. (A related risk is of course FCA retaliation claims.)

Note also that relators increasingly come from the ranks of service providers to defendants — consultants, auditors, or vendors — who parlay temporary insider knowledge of a defendant’s conduct into an FCA claim. Finally, physicians who disapprove of the actions of insurers are another growing source of qui tam litigation.

While FY 2025 was a unique and record-setting year for FCA cases in many respects, it also affirmed that many of our long-standing conclusions about the use of the FCA in health care cases remain true. Settlements and judgments in health care cases continue to represent the majority of FCA resolution dollars even though such cases do not represent the majority of FCA cases overall. And, perhaps for this reason, health care enforcement remains a high priority for the government as well as qui tam relators and their counsel, even in the face of DOJ’s staffing shortages and constitutional challenges to the FCA qui tam provisions.

An intervention rate of 24% is consistent with data from past years. Limited government resources mean that the government will always have to pass on two-thirds to three-quarters of all qui tam cases. That DOJ’s intervention rate has not declined, notwithstanding declining overall DOJ activity and potential loss of staff, is further evidence of the importance of health care–related cases to DOJ.

Read Our Report

The New Normal (FY 2018-2023) DOJ volume surges, qui tam volume is stagnant.

Government health care case volume more than doubles (up 110%) over FY 2025

Qui tam volume grows 24%; total health care volume up 40%

Washington, DC KSLovitch@mintz.com +1.202.434.7324

Chair, Health Law Practice & Chair, Health Care Enforcement Defense Practice

Karen S. Lovitch

Author

health care enforcement defense chair

Nicole Teo, Project Analyst in the firm’s Washington, DC office.

Isabel Coberly, Project Analyst in the firm’s New York office.

Contributors

Boston, MA KMcGinty@mintz.com +1.617.348.1688

Co-chair, Class Action Practice & Member, Health Care Enforcement Defense Practice Boston

Kevin M. McGinty

In Mintz’s annual report on False Claims Act case activity, we examine health care enforcement trends, predict how health care enforcement may evolve, and offer practical guidance about what these trends and predictions mean for health care providers, payors, and other stakeholders.

https://www.justice.gov/opa/media/1424121/dl .

Despite the significant increase in overall cases initiated, the number of cases initiated by the government (401) — including pre-suit investigations by DOJ and agency

Samantha P. Kingsbury, Of Counsel in the firm's Boston office.