In April of 2026, at the initiative of President Trump, the U.S. Department of Justice established the National Fraud Enforcement Division (“the Fraud Division”) as a single-mission unit dedicated entirely to fighting fraud. The division scaled to approximately 500 attorneys and staff by late August, with continued growth planned over the next two years. It’s structured to operate with fewer administrative layers and a more direct reporting chain than prior enforcement units.
The Fraud Division has named healthcare fraud as one of its primary concerns, citing telemedicine schemes, Medicare/Medicaid fraud, controlled substance diversion, and home health and hospice fraud as focus areas. The division has stated it will build on the existing Health Care Fraud Strike Force model with greater resources, data analytics support, and additional technology.
To date, the Government Accountability Office estimates the federal government loses between $233 billion and $521 billion annually to fraud. The Fraud Division has been structured to address those losses through dedicated investigative and prosecutorial resources.
Assistant Attorney General Colin M. McDonald, who heads the Fraud Division, has stated the division will, “…pursue the worst actors — those who prey on the vulnerable and exploit the generosity of Americans in pursuit of illicit profits.”
In August 2026, the DOJ charged 19 defendants in a Philadelphia-area home care fraud scheme involving more than $4 million in fraudulent Medicare and Medicaid claims. In one instance, a single home health aide allegedly billed for over 1,100 instances of overlapping hours across seven clients simultaneously, generating more than 64,000 fraudulent billing hours and over $1.2 million in improper Medicaid payments. That case is part of a strike force that has prosecuted more than 6,200 defendants nationally, with total recovered and charged fraud figures reportedly topping $45 billion.
The creation of the National Fraud Enforcement Division and its emphasis on the healthcare industry reflects a structural change in federal fraud enforcement: more staff, more resources, a dedicated healthcare fraud infrastructure, and a stated intent to keep growing for at least two more years. Healthcare professionals would be well-served to stay mindful of their billing practices, internal controls, and compliance programs in the face of the DOJ’s growing scrutiny.
This material has been prepared for informational purposes only, and is not intended to provide or be relied upon for legal or tax advice. If you have any specific legal or tax questions regarding this content or related issues, please consult with your professional legal or tax advisor.
