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).
Behavioral health providers in the District of Columbia (“District” or “D.C.”) are operating in an environment of heightened government scrutiny. In recent months, federal and District authorities have signaled an intensified focus on Medicaid fraud in the behavioral health space, combining criminal prosecutions by the U.S. Attorney’s Office with aggressive program integrity actions by the D.C. Department of Health Care Finance (“DHCF”). These efforts have included criminal and civil investigations into alleged billing irregularities and, at an increasing rate, the suspension of Medicaid payments to providers based on suspected fraud. Such suspensions are implemented in almost all cases, as permitted by regulations, before any final determination on the merits. These developments raise significant legal, financial, and operational risks for behavioral health providers in D.C.
Our colleagues at Epstein Becker Green released a client alert: "DC Circuit Strongly Reaffirms the Applicability of the Attorney-Client Privilege to Internal Compliance Investigations," by George B. Breen, Jonah D. Retzinger, Marshall E. Jackson Jr., and Stuart M. Gerson.
Following is an excerpt:
Especially in the District of Columbia Circuit, the home base for many fraud cases in which the government is opposed to health care providers and defense contractors, there had been considerable doubt that the attorney-client privilege attached to internal compliance ...
Recent Updates
- Congressional Action on Health Care Cybersecurity: HISAA is Re-Introduced and the Health Care Cybersecurity and Resiliency Act Moves Forward
- DOJ Corporate Fraud Enforcement Memo: What Health Care Companies Need to Know Now
- Attorneys General of Three States File Two Sweeping Lawsuits Targeting Telehealth Abortion Providers and State Shield Laws
- RFI Seeks Input on Medicare Part D’s Pharmacy Contract Standards
- Proposed H.R. 10336 Would Balance Innovation, Access to Dietary Supplements—Yet Change the Definition