March 06, 2026 | Posted By: Sean Estes
The federal government’s most powerful fraud-fighting tool is undergoing significant change. The False Claims Act (FCA) is being stretched in new directions by President Trump’s administration, tested in federal court, and watched closely by anyone who suspects that a company or employer is defrauding the government. If you are a whistleblower, a healthcare worker, a government contractor, or simply someone who knows about fraud involving federal dollars, here is what you need to understand about where the law stands today.
Record-Breaking Enforcement and New Targets
The U.S. Department of Justice reported that FCA enforcement produced more than $6.8 billion in settlements and judgments in fiscal year 2025, the largest annual recovery in the law’s history. Of that total, more than $5.3 billion came from cases that were originally filed by private whistleblowers, known in legal terms as “qui tam relators.”
Those whistleblowers were rewarded handsomely for their courage. The DOJ paid out more than $330 million in whistleblower awards as a share of the funds recovered on behalf of the government. And they filed a record 1,297 qui tam lawsuits.
Healthcare fraud dominated the headlines, accounting for more than $5.7 billion of last year’s total. High-profile settlements included a nearly $1 billion judgment against a major pharmacy company for false prescription claims, a $450 million settlement involving a generic drug manufacturer, and a $1.6 billion verdict against a pharmaceutical company for promoting HIV drugs for unapproved uses. The government also resolved a massive defense contractor case for $428 million, involving false cost and pricing data submitted to the Department of Defense.
The takeaway is simple: the FCA is not a niche legal theory. It is one of the most active areas of federal enforcement in the country, and it shows no signs of slowing down.
The Trump Administration’s New Enforcement Priorities
Every presidential administration shapes FCA enforcement in line with its priorities, and the current administration is no exception.
While healthcare fraud remains the backbone of FCA enforcement, the Trump administration has signaled its intent to expand the law into two new, politically charged areas.
The first is healthcare services related to gender transition for minors. The Attorney General issued a directive instructing the DOJ’s Civil Division to investigate potential false claims related to such services, and federal subpoenas have already been issued to certain healthcare providers.
The second is diversity, equity, and inclusion (DEI) programs. The DOJ announced that it would use the FCA to pursue recipients of federal funds that it determines are promoting discriminatory DEI policies. A senior DOJ official recently confirmed that the department is actively investigating companies that made hiring and promotion decisions based on race or sex. Importantly, the DOJ is not just looking for outright fraud. It is scrutinizing compliance certifications. If a company certified to the government that it had no “illegal DEI” programs, and a whistleblower comes forward with evidence that the certification was inaccurate, that certification itself could form the basis of a false claims case.
This is a concept called “false certification,” and it represents one of the most significant compliance risks companies face today. False certification cases arise not just from overbilling or submitting fraudulent invoices, but from certifying that certain conditions exist when they do not, whether those conditions involve cybersecurity standards, origin-of-goods representations in trade and customs contexts, or, now, potentially, DEI compliance.
Legal experts have noted that these new areas may be difficult for the government to pursue successfully, at least initially, because the legal standards are still being defined. But whistleblowers and their attorneys are watching closely, because the first cases in novel areas can shape years of enforcement that follow.
A Constitutional Challenge That Could Change Everything
Perhaps the most significant development in the FCA world is a case now pending before the U.S. Court of Appeals for the Eleventh Circuit: U.S. ex rel. Zafirov v. Florida Medical Associates LLC. We covered this case in depth in an earlier post, DOJ Reports $6.8 Billion in False Claims Act Recoveries as a Constitutional Challenge to Qui Tam Moves Closer to Supreme Court Review, and the Eleventh Circuit appeal has continued to develop in important ways since then.
The case originated when a whistleblower, Clarissa Zafirov, sued her employer in 2019 for allegedly misrepresenting patients’ medical conditions to Medicare, a practice that led the government to overpay under the Medicare Advantage program. The government chose not to actively participate in the case, leaving Zafirov to pursue the claims on its behalf for 5 years.
In September 2024, the trial court issued a remarkable ruling: it found that the qui tam provisions of the False Claims Act, the very provisions that allow private citizens to file fraud suits on behalf of the government, are unconstitutional. The court reasoned that by filing and pursuing these cases, whistleblowers exercise executive power that is reserved to the government alone, and since whistleblowers are not appointed through the constitutional process governing government officers, they should not be permitted to do so.
This ruling breaks from decades of legal precedent. The FCA’s qui tam provisions have existed since 1863 and have historically withstood constitutional scrutiny. But the Eleventh Circuit, which covers Florida, Georgia, and Alabama, is now weighing the issue on appeal. The outcome could affect not just cases in those states, but could set the stage for review by the U.S. Supreme Court, where at least one Justice has already expressed skepticism about the constitutionality of the qui tam framework.
If the qui tam provisions were ultimately struck down, the impact on fraud enforcement would be enormous. The government simply does not have the resources to investigate every case that whistleblowers currently bring forward. Private relators have been essential to recovering billions of taxpayer dollars that would otherwise never have been identified. Legal observers believe that if the Supreme Court were to strike down the qui tam provision, Congress would face enormous pressure to restore some version of the system, but that process would take time, and fraud would continue in the interim.
For now, the law remains in effect and whistleblowers continue to have the right to file qui tam cases. The trial court’s existing decision appears to apply primarily to cases in which the government declines to intervene, which represents the vast majority of qui tam actions. If the government does choose to intervene and take the lead in a case, the constitutional concerns raised in Zafirov are less likely to apply.
What This Means If You Know About Fraud
Despite the legal uncertainty swirling around the FCA, one message from legal experts is consistent: do not assume the risk of fraud enforcement is decreasing. If anything, it is expanding into new areas, and the financial incentives for whistleblowers remain powerful.
If you work in healthcare, government contracting, pharmaceuticals, defense, education, or any industry that receives federal funds, and you have knowledge of fraud being committed against the government, the FCA may give you the right to file a qui tam lawsuit and share in any recovery. Depending on the outcome, whistleblower awards under the FCA typically range from 15% to 30% of the amount the government recovers. In multimillion-dollar cases, that can mean life-changing compensation.
It is also important to understand that the FCA provides strong protections against retaliation. If your employer has taken adverse action against you, such as termination, demotion, or harassment, because you reported or refused to participate in fraud against the government, you may have independent claims for reinstatement, back pay, and damages.
The window to act matters. Qui tam cases are filed under seal, meaning they are kept confidential initially, and the government has time to investigate before any defendant is notified. An experienced whistleblower attorney can help you assess whether your information supports a viable claim, guide you through the qui tam filing process, and protect your rights throughout the case.
Talk to a Whistleblower Attorney
At Hoyer Law Group, PLLC, our attorneys have represented whistleblowers in False Claims Act cases involving healthcare fraud, education fraud, defense contractor fraud, and more. We have helped clients recover millions of dollars on behalf of the government and themselves. Our team closely monitors developments in FCA law, including the Zafirov case and the Trump administration’s evolving enforcement priorities, so we can provide you with the most current and practical guidance possible.
If you have knowledge of fraud against the government and want to understand your options, contact us for a confidential evaluation. There is no cost to speak with us, and everything you share is protected by attorney-client privilege. Call us at (844) 531-0082 or reach out online to get started.
This blog is for general informational purposes only and does not constitute legal advice. For advice specific to your situation, please consult a qualified attorney.