By: Christopher Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, MA
A Health Care Provider Defense and Compliance Firm
The Department of Justice’s new National Fraud Enforcement Division has now published its enforcement priorities and health care is one of the central targets. The August 13, 2026 memorandum makes clear that DOJ intends to use more prosecutors, more data analytics and more coordinated enforcement to pursue significant fraud schemes across Medicare, Medicaid, telemedicine, controlled substances, home health and hospice.
The scale of the DOJ buildout is notable. DOJ states that the new Fraud Division is being expanded to approximately 500 attorneys and staff with plans for continued growth over the next two years. Prosecutors will be supported by data scientists, asset recovery attorneys, investigators, appellate counsel, privilege review teams and advanced litigation technology. The Division also plans to work closely with U.S. Attorneys’ Offices and federal, state and local enforcement partners.
For health care providers, the most important section of the memo is blunt. DOJ says national health care expenditures are expected to grow from more than $3 trillion annually to more than $7 trillion with an estimated 3 to 10 percent lost to fraud. The Division specifically identifies telemedicine fraud, Medicare and Medicaid fraud, controlled substance diversion, home health and hospice schemes and deceptive marketing of unsafe health care products and services as enforcement priorities.
DOJ also says it intends to “supercharge” the Health Care Fraud Strike Force model with greater resources, stronger data analytics and better technology. That language matters. Enforcement will increasingly begin with data. Billing outliers, unusual utilization, referral patterns, controlled substance prescribing, rapid revenue growth and geographic anomalies can all become investigative leads before a whistleblower ever calls the government.
Corporate liability is also squarely on the table. The memo states that DOJ has a strong pipeline of corporate matters and will prioritize anti-fraud corporate enforcement. At the same time, the Division says it will reward organizations that voluntarily self-disclose misconduct, cooperate with investigations and remediate identified problems.
That creates both risk and opportunity for providers. Organizations that identify billing, kickback, medical necessity or documentation problems early may have meaningful options to investigate and remediate before the issue becomes a criminal investigation. Those who ignore warning signs may face a far more coordinated federal response than in the past.
The call to action is straightforward. Providers should assume DOJ has the ability to analyze their billing patterns at scale, in real time. Conduct privileged data reviews before the government does. Examine high-growth service lines, telehealth billing, controlled substance prescribing, referral arrangements, home health and hospice utilization, and any business model that depends heavily on federal reimbursement. Make sure compliance concerns are investigated quickly and elevated to counsel when necessary.
The enforcement environment has changed. DOJ now has a dedicated national division whose stated mission is to find fraud faster and prosecute it more aggressively. Compliance is no longer merely defensive. It is the first line of protection. If you have questions about health care fraud exposure, internal investigations or proactive compliance reviews and risk assessments, please contact Parrella Health Law at 857.328.0382 or Chris directly at cparrella@parrellahealthlaw.com.