DOJ Launches New FCA Initiative

The U.S. Department of Justice (DOJ) recently announced a new initiative to enhance its working relationship with data miners who bring cases as whistleblowers under the False Claims Act (FCA).^[1] The initiative is dubbed “FOCUS,” an acronym for Fraud Oversight through Careful Use of Statistics.

There has been a sharp increase in qui tam complaints brought by Relators who are not traditional “company insiders” but rather businesses and individuals who analyze publicly available government data for potential fraud that can support a FCA case. Under FOCUS, the DOJ Civil Division will “prioritize working with data miners that demonstrate an insightful application of sophisticated technological capabilities to regulatory frameworks to help identify potential fraud that would otherwise go undetected.” In announcing the new initiative, Assistant Attorney General Brett A. Shumate explained DOJ’s understanding that “[s]ophisticated data analytics have become an increasingly important means of identifying fraud trends and uncovering patterns of misconduct across federal programs” and affirmed DOJ’s “commitment” to “engaging with the strongest and most effective partners in the war against fraud.” Deputy Assistant Attorney General Brenna E. Jenny commented that the Civil Division is interested in engaging with data miners “who believe that they have developed particularly effective tools for detecting fraud” and that “[p]articipants should be prepared to explain what differentiates their approach, how they validate their findings, and why their methodology provides a reliable basis for identifying high-quality, actionable False Claims Act matters.”

Through FOCUS, data miners will be invited to meet with DOJ to explain “their capabilities and outline why and how their data signals reliably correlate to fraud.” While such a meeting is not a pre-filing requirement, DOJ “will prioritize working with data miners that have demonstrated an investment in pre-filing diligence and commitment to analytical rigor, familiarity with program rules, and legally sufficient allegations.” The announcement included a dedicated email address for data miners interested in scheduling a meeting: [email protected].

This new program is just another example of how DOJ is weaponizing advanced data mining techniques to investigate and prosecute fraud under the FCA. Last year, as part of the national health care fraud takedown in June 2025, DOJ had announced the creation of “a Health Care Fraud Data Fusion Center to bring together experts from the Department’s Criminal Division, Fraud Section, Health Care Fraud Unit Data Analytics Team; HHS-OIG; FBI; and other agencies to leverage cloud computing, artificial intelligence, and advanced analytics to identify emerging health care fraud schemes.”^[2] The following month, DOJ announced a new DOJ-HHS FCA Working Group and stated that it would be “leveraging HHS resources through enhanced data mining and assessment of HHS and HHS-OIG report findings.”^[3]

What all this means, as a practical matter, is that maintaining good regulatory compliance hygiene has never been more important for healthcare providers. The enforcement tools at the government’s disposal are becoming increasingly sophisticated and billing improprieties that once might have escaped the notice of regulators are now more likely than ever to be identified, investigated and potentially prosecuted under the FCA and other laws. If you have any questions about the new DOJ initiative or wish to consult on a compliance matter, you may contact the author at [email protected] or (516) 357-3161.

[1] https://www.justice.gov/opa/pr/civil-division-announces-focus-initiative-data-miners-filing-qui-tam-complaints

[2] https://www.justice.gov/opa/pr/national-health-care-fraud-takedown-results-324-defendants-charged-connection-over-146

[3] https://www.justice.gov/opa/pr/doj-hhs-false-claims-act-working-group