Over the past week, the Department of Justice (DOJ) has taken actions that have solidified its authority and commitment to fighting fraud in health care. On August 13, 2026, DOJ released a memorandum that includes health care among five enforcement priority areas that DOJ has identified for its National Fraud Enforcement Division (the Fraud Division). In targeting this area, DOJ cites national health care expenditures as expecting to grow from over $3 trillion a year to over $7 trillion and estimates that between 3–10% of that amount is lost to fraud. DOJ states that it will use “cutting-edge data analysis to target exploitative health care fraud schemes, including in telemedicine programs, Medicare or Medicaid fraud, controlled substance diversion, home health and hospice schemes, and companies and individuals that deceptively market unsafe products and services.”

Following the release of the memorandum, DOJ issued a final rule on August 18 that formally delegates certain powers and authorities to the Assistant Attorney General for the Fraud Division, including those that were previously delegated to the Assistant Attorney General for the Criminal Division. Among the functions that are assigned to the Fraud Division are criminal proceedings: (1) involving fraud or abuse with respect to health plans; and (2) related to health care fraud and controlled substances distribution and diversion schemes. The final rule, which takes effect on August 24, provides the Fraud Division with expansive authority to oversee cases within the Department, bring actions for injunctions against fraud, and prosecute federal criminal provisions.

Both of these actions serve to further the administration’s “whole-of-government approach to combating fraud.” DOJ’s efforts to formalize the Fraud Division’s authority over prosecuting health care fraud and build its enforcement capacity also complements actions that the federal government has taken throughout the year targeting fraud in health care. As we’ve previously reported, this past spring, citing concerns about fraud in the home health and hospice sector, the Department of Health and Human Services (HHS) issued nationwide moratoria on new home health and hospice Medicare enrollments. More recently, HHS expanded the delegation of exclusion authority to the Centers for Medicare and Medicaid Services (CMS) and proposed regulations that would significantly increase the bases for Medicare provider enrollment denials and revocations. Additionally, the administration’s messaging around fraud in Medicaid appears to target home and community-based services. All of these actions have implications for our members’ ability to provide critical services to older Americans. We can expect an increase in the scrutiny of Medicare and Medicaid providers, as well as fraud-related prosecutions, especially as DOJ works to build the Fraud Division’s capacity to approximately 500 attorneys and staff.

While LeadingAge supports efforts to combat fraud in health care, which is concerning to all our members, we continue to stress the need for these efforts to not only root out bad actors but also protect legitimate providers through targeted evidence-based approaches.