On April 30, 2026, the newly constituted National Fraud Enforcement Division (NFED) of the U.S. Department of Justice announced the formation of a West Coast Health Care Fraud Strike Force.
This new Strike Force combines the resources of DOJ’s Health Care Fraud Unit (which was recently placed under operational control of NFED, as discussed below) and the U.S. Attorney’s Offices (USAOs) for the Districts of Arizona, Nevada, and the Northern District of California.
The Strike Force model, developed almost 20 years ago by the DOJ’s Criminal Division, Fraud Section, has been the most prolific criminal health care fraud prosecuting unit in all of DOJ, having prosecuted more than 6,200 defendants in total. With this model delivering such consistent results to DOJ, it is not surprising that the NFED would wish to implement it for its own mission.
Per the press release announcing the new Strike Force, the NFED will “coordinate closely” with the USAOs to establish the Strike Force and will partner with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the Drug Enforcement Administration (DEA), and other law enforcement partners.
DOJ’s April 30 announcement states that “health care fraud in these districts imposes an enormous and growing burden on American taxpayers and undermines the integrity of Medicare, Medicaid, and TRICARE…” The announcement continues: “The Strike Force’s west coast expansion makes clear that the [NFED] will use every available legal tool to identify, investigate, and prosecute these offenses.”
National Trend
DOJ is leading major efforts to combat health care fraud, particularly fraud impacting the Medicare and Medicaid programs. Since its launch in January, the NFED has been active in this mission, including its strong focus on alleged health care fraud in Minnesota.
On April 7, in a surprise move, Acting Attorney General Todd Blanche announced via a detailed memo that the NFED would assume operational control of the Health Care Fraud Unit in the Criminal Division’s Fraud Section, the home of the Strike Force. In addition to these criminal enforcement efforts, there have been numerous indications from the administration since January 2025 of an increased emphasis on the use of the civil False Claims Act in health care investigations.
We’ve previously written about the congressional investigation into California’s oversight of its federally funded hospice programs, as well as a crackdown by the Centers for Medicare and Medicaid Services (CMS) into New York’s oversight of its Medicaid program. While California and Nevada predominantly vote “blue”—adding to charges of political retaliation against “blue” states—Arizona’s voting has leaned Republican in three of the last four presidential elections.
Nevertheless, the DOJ’s announcement of the West Coast Strike Force builds off recent landmark prosecutions of digital health technology executives in the Northern District of California and the “dismantling of Medicaid, sober home, and wound care fraud schemes” in the District of Arizona. The DOJ highlights these regions specifically because data analytics demonstrate the migration of fraud schemes to Arizona and Nevada; and that “Silicon Valley [California] has become ground zero for technology-driven health care fraud schemes that seek to cheat taxpayer-funded programs like Medicare.” The DOJ’s announcement further cites the expansion of the New England Strike Force program to the District of Massachusetts in 2025; and 2025’s record-breaking National Health Care Fraud Takedown.
Takeaways
These developments suggest that the administration continues to be interested in investigating and enforcing laws regarding suspected fraud, waste, and abuse in the health care industry. The geographic coverage of the Strike Force also shows that the administration is expanding its lens of focus beyond specific regions previously flagged as hot spots for suspected fraud, as was the case with alleged hospice fraud in Southern California.
The DOJ’s announcement also highlights the agency’s use of data-driven prosecutions, underscoring the need for compliance frameworks in line with HHS-OIG guidance, focused audits of billing and coding submitted to federal health care programs, and well-maintained documentation.
Stakeholders in the health care industry should note that the DOJ again calls on whistleblowers to report wrongdoing; and references its corporate enforcement and voluntary self-disclosure policy (CEP) for criminal matters, which the agency launched on March 10, 2026.
As EBG wrote in March 2026, the new CEP creates a nationalized policy for how DOJ awards companies cooperation credit for self-disclosure. The CEP incentivizes companies to voluntarily disclose discovered misconduct, cooperate with DOJ investigations, and timely and appropriately remedy discovered wrongdoing in exchange for credit, either through a declination of prosecution or a non-prosecution agreement.
Whether it is DOJ, CMS, HHS, or state Medicaid Fraud Control Units that come knocking, the government is persisting in its efforts to investigate and prosecute fraud, waste, and abuse in health care. Resolutions of Medicare and Medicaid fraud cases (whether by guilty plea, trial conviction or civil settlement) return funds to both federal and state government coffers, making them attractive efforts for the Administration to undertake. As always, strong organizational compliance programs and internal investigative processes are key, especially for health care stakeholders and providers.
Ann W. Parks contributed to this article
