DOJ Corporate Fraud Enforcement Memo: What Health Care Companies Need to Know Now

On October 1, 2026, the Department of Justice (DOJ) National Fraud Enforcement Division (NFED) issued clear directives regarding the priorities of its Corporate Enforcement Section (CES) in a memorandum (the “CES Memo”).

Assistant Attorney General Colin M. McDonald announced that prosecutors will take “an aggressive, all-tools approach” to investigating fraud priorities, with health care fraud at the top of the list. The CES Memo follows an August 24, 2026, assignment of criminal health care investigations to NFED, and McDonald’s August 13, 2026, announcement of NFED fraud enforcement priorities—in which health care and corporate misconduct made the top five (see Epstein Becker Green blog post here).

NFED, established in April 2026, aims to “zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars” through the coordinated efforts of government agencies, state and local law enforcement, and other steps to centralize fraud enforcement (see related blog post here). While such enforcement is not new, NFED represents a significant structural shift as well as a targeted focus. DOJ prosecutors will be carrying out coordinated efforts against fraud, leveraging statutes, including the civil False Claims Act (FCA); the criminal Anti-Kickback Statute (AKS); the Food, Drug, and Cosmetic Act (the “FD&C Act”); and statutes related to federal tax enforcement. Importantly, entities operating in the health care space will continue to be closely scrutinized for fraudulent activity, especially with respect to federal programs like Medicare and Medicaid.

The CES Memo reiterates that combating health care fraud remains a top priority of DOJ, with aggressive enforcement directed against both individuals and corporations. Health care executives, compliance officers, and corporate counsel should take the time to assess vulnerabilities before DOJ comes knocking.

Principles of Corporate Enforcement

NFED intends to “zealously prosecute corporate actors that defraud taxpayers and the United States of America” while guarding against interference with legitimate business operations. To that end, prosecutors intend to follow DOJ policies concerning corporate enforcement, including DOJ’s Principles of Federal Prosecution of Business Operations and the Corporate Enforcement and Voluntary Self-Disclosure Policy. If prosecutors are familiarizing themselves with these principles, health care stakeholders should be, too.

Corporate Enforcement Section

The new CES within NFED will coordinate all corporate fraud investigations to ensure the “consistent, fair, and successful prosecution of corporate crime across [NFED’s] entire fraud portfolio.” NFED prosecutors were required to report ongoing corporate investigations to CES by October 8, 2026. CES will be “promptly notified” of new corporate investigations and of major developments in ongoing cases. It will also evaluate a company’s compliance with the terms of any corporate resolution and account for “important differences in subject matter areas such as health care … when determining an appropriate course of conduct in a corporate case.” Compliance officers and general counsel need to be monitoring these DOJ policy shifts.

Corporate Investigations and Enforcement Actions

DOJ’s top priority is investigating “[f]raud schemes involving the health care industry, including health care fraud, distribution of controlled substances, and violations of the [FD&C Act].” Prosecutors will weigh factors including:

• Knowledge of or involvement by corporate management;
• Efforts to conceal fraud from government agencies or auditors;
• Conduct furthering a fraud scheme lasting three or more years;
• Conduct affecting multiple taxpayer-funded programs (e.g., Medicare, Medicaid) or causing substantial financial harm to these programs;
• Conduct spanning three or more federal districts;
• Losses of $25 million or more or harm to 25 or more victims; and
• Any other factor relevant to the Justice Manual (see related blog post here).

Takeaways: Compliance, Cooperation, Controls

DOJ, in consultation with law enforcement partners, will be carrying out policies to incentivize both companies that voluntarily cooperate and whistleblowers who come forward with respect to fraud. While DOJ’s Civil Division, which enforces the FCA, remains separate from NFED, FCA cases are often brought by whistleblowers, and DOJ’s Civil Division will not be siloed. Expect parallel proceedings between civil FCA suits and criminal NFED prosecutions, particularly in the corporate space, where investigations are on the rise. As always, companies operating in the health care space should do the following:

Strengthen Compliance and Internal Controls

Conduct thorough compliance audits across all operations; document and strengthen compliance programs; and create clear policies with respect to, for example, health care billing, FCA and AKS compliance, and Food and Drug Administration compliance.

Implement Proactive Disclosure Mechanisms

Now more than ever, DOJ is implementing policies to incentivize companies that voluntarily self-disclose misconduct. Establish robust internal reporting mechanisms, consider voluntary self-disclosure if misconduct is discovered, and cooperate fully with government investigations. Think like a prosecutor: review DOJ’s Principles of Federal Prosecution of Business Operations and the Corporate Enforcement and Voluntary Self-Disclosure Policy.

Scrutinize Duration and Scope of Conduct

DOJ will place great weight on whether fraudulent conduct (i) lasted three years or more, (ii) affected multiple taxpayer-funded programs, (iii) spanned three federal districts, or (iv) resulted in more than $25 million in losses or harm to 25 or more victims. Audit whether any practices fall into these categories.

Watch the Data

The government is heavily relying on data analytics and artificial intelligence, and hiring more prosecutors to “[build] out a full-fledged law firm” despite mass government attrition, as Law360 has reported. Stay vigilant.

If you have questions, please reach out to the authors.

Epstein Becker Green Staff Attorney Ann W. Parks contributed to the preparation of this post.

* * * *

If you have questions, please reach out to the author(s).

The Health Law Advisor blog is currently edited by Emily Chi Fogler.