The first year of the second Trump Administration has brought with it a series of pronouncements about the Administration’s policy objectives and enforcement priorities. And this time around, the two have merged. The FCA in particular has emerged as a preferred legal avenue for inducing government contractors and other recipients of federal funds to alter their practices. Both the White House and the DOJ have taken steps to meld policy goals with FCA enforcement efforts.
For example, as we discuss elsewhere in this Guide, the Administration has focused its sights on dismantling DEI programs and reenvisioning compliance with civil rights laws, using the FCA to give shape to these objectives. Directives from the White House and the DOJ over the first half of 2025 focused heavily on those new priorities, leaving businesses to strategize about how to respond. Since then, the DOJ has also announced its continued commitment to combatting fraud, waste, and abuse in the health care sector by establishing a joint FCA Working Group with the Department of Health and Human Services (HHS) and identifying gender-affirming care as a policy and enforcement target. Taken together, the government has signaled an expansive approach to FCA enforcement as the second year of the Administration begins.
The Administration’s 2025 directives
January 21, 2025, Executive Order (EO) 14173 and February 5, 2025, Bondi Memorandum
The day after his inauguration, President Trump issued EO 14173 (Ending Illegal Discrimination and Restoring Merit-Based Opportunity), announcing the Administration’s goal to end DEI initiatives that the Administration deemed discriminatory. In relevant part, the EO directed agencies to require parties contracting with the federal government to certify compliance with anti-discrimination laws and to agree that compliance with such laws is material to government payment decisions under the FCA. With this EO, the Administration anticipated – and sought to remove – a potential hurdle in FCA enforcement targeting DEI initiatives.
Soon after EO 14173, Attorney General Pam Bondi issued a memorandum (Bondi Memorandum) to all DOJ employees on the day that she was sworn in, geared toward Ending Illegal DEI and DEIA [Diversity, Equity, Inclusion, and Accessibility] Discrimination and Preferences. The Bondi Memorandum, although not specifically focused on the FCA, directed the DOJ’s Civil Rights Division to “investigate, eliminate, and penalize illegal DEI and DEIA preferences, mandates, policies, programs, and activities in the private sector and in educational institutions that receive federal funds.”
May 19, 2025, Blanche Memorandum
Several months after EO 14173 and the Bondi Memorandum, Deputy Attorney General Todd Blanche followed up with the issuance of a “Civil Rights Fraud Initiative” memorandum (Blanche Memorandum). The Blanche Memorandum directed the DOJ’s Civil Division’s Fraud Section and Civil Rights Division to co-lead a civil rights initiative pursuing FCA allegations against recipients of federal funds “that knowingly violate[] federal civil rights laws.” The Blanche Memorandum called for “vigorous enforcement” of the FCA and collaboration between federal, state, and local authorities. It also encouraged private citizens to bring whistleblower suits under the FCA. Like other policy pronouncements by the Administration, the Blanche Memorandum specifically called out higher education, providing an example that “a university that accepts federal funds could violate the [FCA] when it encourages antisemitism, refuses to protect Jewish students, allows men to intrude into women’s bathrooms, or requires women to compete against men in athletic competitions.”
June 11, 2025, Shumate Memorandum
Civil Division Assistant Attorney General Brett Shumate issued his own memorandum on the day that he was sworn in. Shumate distributed a memorandum (Shumate Memorandum) to all DOJ Civil Division employees describing “Civil Division Enforcement Priorities” in light of President Trump and Attorney General Bondi’s directive that “the Civil Division [] use its enforcement authorities to advance the Administration’s policy objectives.” The Shumate Memorandum instructed Civil Division attorneys to prioritize investigations and enforcement actions in furtherance of the following policy objectives: (i) Combatting Discriminatory Practices and Policies; (ii) Ending Antisemitism; (iii) Protecting Women and Children; (iv) Ending Sanctuary Jurisdictions; and (v) Prioritizing Denaturalization.
The Shumate Memorandum reiterated the Civil Division’s commitment to “aggressively investigate, and as appropriate, pursue [FCA] violations against recipients of federal funds that knowingly violate civil rights laws,” and to coordinate with the Civil Rights Division, relators and other whistleblowers, and federal agencies to support these efforts. This memo explained that enforcement efforts include prioritization of “investigations and enforcement actions against entities that make claims for federal funds but knowingly violate federal civil rights laws by participating in or allowing antisemitism.”
The Shumate Memorandum also cited to prior directives by Attorney General Bondi to pursue FCA investigations related to gender affirming care; and it instructed the Civil Division to use “all available resources to prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities consistent with these directives.” This includes “aggressive” pursuit of FCA claims “against health care providers that bill the federal government for impermissible services” such as “providers that attempt to evade state bans on gender dysphoria treatments by knowingly submitting claims to Medicaid with false diagnosis codes.”
July 2, 2025, DOJ press release
Following six months of government signals of enforcement efforts targeted to new policy objectives, a DOJ press release announced a DOJ-HHS FCA Working Group (Working Group) intended to enhance collaboration across agencies to combat health care fraud, a historic area of FCA focus for the DOJ and HHS. The Working Group’s priority enforcement areas include: (i) Medicare Advantage; (ii) drug, device, or biologics pricing, including arrangements for discounts, rebates, service fees, and formulary placement and price reporting; (iii) barriers to patient access to care, including violations of network adequacy requirements; (iv) kickbacks related to drugs, medical devices, durable medical equipment, and other products paid for by federal health care programs; (v) materially defective medical devices that impact patient safety; and (vi) manipulation of Electronic Health Records systems to drive inappropriate utilization of Medicare covered products and services. This announcement is consistent with other of the Administration’s health care policy objectives, such as lowering drug pricing. The press release, like other recent government directives, encourages cross-agency collaboration and whistleblower reports.
Looking ahead
The through line in each of these pronouncements is that the Administration sees the FCA as a key weapon to support its policy goals. The subtext to that through line is a message encouraging whistleblowers to invoke the FCA’s qui tam provision. The Administration’s proactive approach to using FCA enforcement to advance its goals may lead to creative allegations from the relator’s bar and beefed-up enforcement in the targeted policy areas and industries. But it remains to be seen whether the government or an empowered whistleblower bar will prevail on creative theories in court.
In the months since these directives were issued, we’ve seen the DOJ ramp up investigative efforts in the Administration’s focus areas – with varying degrees of success. For example, this summer, the DOJ issued more than 20 subpoenas to hospitals and clinics that provide gender-affirming care. Although the government has argued in response to motions to quash that the subpoenas were part of a legitimate investigation into violations of (among other things) the FCA, at least two courts have found the DOJ’s reasoning pretextual. In the QueerDoc matter, a judge in the Western District of Washington found that the subpoena to QueerDoc was issued to “intimidate and coerce providers into abandoning lawful medical care” – not to investigate health care fraud violations. The QueerDoc court reached this conclusion in part because of statements by DOJ leadership and the White House articulating the Administration’s goal of “eliminating” gender-affirming care. A District of Massachusetts judge made similar findings in a matter related to a subpoena sent to Boston Children’s Hospital. The close link between the Administration’s policy aims and its FCA enforcement priorities may continue to prove a stumbling block as these matters reach the courts.
At the same time, the Centers for Medicare & Medicaid Services (CMS) issued a December 19, 2025 Proposed Rule that would revise the conditions of participation for Medicare and Medicaid certified hospitals, prohibiting them from providing gender affirming care services for minors. Finalization of the Proposed Rule would introduce additional questions and FCA risks not only for hospitals subject to FCA enforcement, but also could be replicated in other industries and policy areas.
Enforcement activity in 2025 shows that in addition to these new and novel applications, the Administration can be expected to continue to vigorously pursue more traditional theories of fraud under the FCA, especially in health care. The DOJ announced significant health care-related FCA settlements in 2025, including those involving allegations of Anti-Kickback Statute violations by Biohaven ($59 million) and Gilead ($202 million); allegations related to submission of false diagnosis codes to the Medicare Advantage program by Seoul Medical Group ($62 million); and allegations related to submission of claims for invalid prescriptions under the Controlled Substances Act by Walgreens ($300 million). Although most of these investigations likely began long before inauguration day, the pace and scope of settlements evidences the DOJ’s continuing commitment to rely on the FCA to address fraud on federal health care programs. Businesses considering their ever-evolving compliance obligations must think beyond the usual levers of enforcement and stay tuned to both official announcements and the actions that the government is taking to advance its policy and enforcement goals.