The Healthcare Industry Remains the Largest Target for False Claims Act Enforcement

The healthcare industry has long been the primary target for False Claims Act (FCA) enforcement, with no other sector in close second place.Over the past year, the federal government has unveiled several new or revamped whistleblower programs, most notably the Department of Justice’s antitrust program, which we have previously written about. However, despite the expanded scope of federal anti-fraud enforcement, it is clear that healthcare spending (and specifically Medicare and Medicaid spending) remains the primary focus for both the United States and private whistleblowers.

Healthcare-Related FCA Recovery in 2024

In 2024, the United States recovered a total of $2.9 billion through False Claims Act litigation. Of that amount, $1.675 billion—or 57.4%—was from healthcare-related cases. In contrast, fraud involving defense spending, which has historically been the other major focus of FCA enforcement, resulted in recoveries of just $93 million—or 3.2%—of the year’s total.

These numbers certainly raise concerns that a significant amount of fraud in military contracting may be going undetected. However, for individuals thinking about blowing the whistle on healthcare fraud, these figures should be reassuring. For all emerging areas of FCA enforcement, there is no question that healthcare fraud remains the top priority for the federal government and will likely remain so for the foreseeable future.

Thinking About Blowing the Whistle on Healthcare Fraud?

As disconcerting as it may be that healthcare fraud is so prevalent, it’s heartening to know that there is an avenue (and potential reward) for individuals to report fraudulent behavior and that the U.S. government is committed to addressing these claims.

Those considering blowing the whistle on an employer or other entity should know that Barrett Johnston Martin & Garrison, PLLC, is committed to representing whistleblowers throughout the country. If you have information or questions regarding a potential case of health care fraud, FCA violations, or kickback schemes, schedule a free and confidential consultation with our firm.