Welcome to Fraud by the Numbers
Welcome to The Anti-Fraud Coalition’s Fifth Annual Fraud by the Numbers! Each year in September, TAF Coalition uses cold, hard numbers and facts to illustrate how fraud costs the government, taxpayers, and market participants – and how impactful whistleblowers can be in stopping that fraud. We will post one blog per business day this month demonstrating what the numbers can teach us about fraud and enforcement. While the fight against fraud is a bi-partisan cause, this is the first year of Fraud by the Numbers that we’ve had to account for and consider a different administration’s enforcement priorities. We are committed to spotlighting the extent to which fraud impacts us and highlighting how the fight may look different under the new administration.
FCA Enforcement: Full Steam Ahead
The False Claims Act remains the federal government’s most effective tool in fighting fraud on the government, and this administration continues to defend the constitutionality of its qui tam provisions. Healthcare fraud, which has been a priority for every administration since the FCA was amended in 1986, continues to be front and center under the Trump administration, with DOJ and the Department of Health and Human Services announcing in July the reestablishment of the DOJ-HHS False Claims Act Working Group aimed at collaboration in the government’s enforcement efforts, perhaps signaling an even greater focus on healthcare fraud, which is already consistently the “leading source of False Claims Act settlements and judgments.” Both the criminal and civil divisions of DOJ have also indicated that customs and tariff fraud is a priority enforcement area, as the Trump administration imposes significantly higher tariffs on imports from nearly every country around the world. We have already seen four FCA settlements in this area in 2025.[1]
The Year of the Trial for Whistleblowers?
Although trials have been historically rare in FCA cases, five have occurred so far in 2025. Some of the judgments are real doozies, including one jury verdict resulting in a judgment of $1.64 billion against Johnson & Johnson, another resulting in a judgment of $290 million against CVS Caremark, and a third verdict resulting in a $949 million judgment against Omnicare and CVS. The Johnson & Johnson case is on appeal to the Third Circuit, and the CVS Caremark and Omnicare judgments will also likely be appealed. In each of these three cases the whistleblower and the whistleblower’s lawyers saw the allegations through to judgment after the government declined to intervene. Stay tuned to find out how much of these gargantuan judgments hold up and are returned to the coffers at CMS to support the Medicare and Medicaid programs.
New FCA Enforcement Priorities
On June 11, 2025, Assistant Attorney General for the Civil Division, Brett Shumate, issued a memorandum announcing five “Civil Division Enforcement Priorities” for the Department of Justice: (1) combatting discriminatory practices and policies, (2) ending antisemitism, (3) protecting women and children, (4) ending “sanctuary” jurisdictions, and (5) prioritizing denaturalization of naturalized U.S. citizens. If those don’t sound like FCA enforcement priorities you’ve heard from DOJ in the past, you are not wrong! However, the Trump administration has made clear that it intends to use the FCA to enforce novel theories of fraud.
The memorandum explains that DOJ will be using the FCA to further its “Civil Rights Fraud Initiative,” which is aimed at using the FCA against recipients of federal funds that engage in what the administration has characterized as “illegal DEI.” Similarly, the memorandum expresses DOJ’s intent to pursue FCA actions against “entities that make claims for federal funds but knowingly violate federal civil rights laws by participating in or allowing antisemitism.”
As to the third priority, the memorandum focuses on gender-affirming care, and promises to “aggressively pursue claims under the False Claims Act against health care providers that bill the federal government for impermissible services.”
DOJ resources devoted to fraud enforcement have always been scarce, particularly when compared to the money corporations spend on in-house and outside counsel, and in 2025 there has been a drastic reduction in staffing at DOJ and across government agencies. Between established priorities like healthcare fraud and the novel application of the FCA to further the President’s policies, those still employed by the federal government employment are being tasked with twice the work and half the resources..
A Long-Anticipated Antitrust Whistleblower Program
While resources may be lacking on the ground for now, the government has re-affirmed the need for whistleblowers to root out fraud in new areas of enforcement. There have been many efforts over the years to implement an antitrust whistleblower program, and in July of 2025, those efforts were successful. Launched in conjunction with the U.S. Postal Service, the new program incentivizes individuals to report information about illegal agreements to “fix prices, rig bids, and allocate markets, as well as other federal criminal violations that impact, distort, or undermine the competitive process or market competition.” This is an incredibly important area of enforcement which impacts every industry. Antitrust enforcement can result in massive fines, but historically only when the government invests vast resources to investigate. This program encourages whistleblowers with knowledge of illegal actions to report the fraud to the government and assist with the government’s investigation, supplementing taxed resources and providing critical information to assist the government.
Dodd-Frank Whistleblower Programs
While a window has been opened for whistleblowers with information about antitrust violations, a door seems to have been shut, at least temporarily, on the Dodd-Frank Whistleblower programs, with awards way down in 2025. According to a Bloomberg Law article published in July, awards under the Securities and Exchange Commission’s program totaled about $20 million for the year, as opposed to about $60 million at the same time in 2024. The SEC is denying a record percentage of whistleblower claims, and has approved only 13% of claims compared to about 37% at the same time last year.
Awards under the Commodities Futures Trading Commission whistleblower program are even more alarming. The CFTC has issued only one award so far in 2025 for $700,000. At this time in 2024, the agency had paid out at least seven awards worth around $20 million.
What to Look Forward to In This Year’s Fraud by the Numbers Series
We are excited to present you with facts and figures related to fraud across programs and industries. Our members will explore trends in healthcare fraud, such as the increase in Medicare Advantage fraud, the increase in private equity in healthcare, drug pricing claims, and more. We will also delve into last year’s numbers at the Dodd-Frank programs and ponder what the future might hold, including for new whistleblower programs, such as the Criminal Antitrust Whistleblower Program. We will highlight enforcement involving state FCA’s, cryptocurrency fraud, and tax fraud; and take a look at cybersecurity, Department of Defense fraud, COVID fraud, and customs fraud.
Fraud by the Numbers is a massive undertaking each year, and we’d like to thank all of our contributors for their time researching, writing, and editing to make this year’s series a success:
– The Anti-Fraud Coalition staff in addition to myself: Grace Swindler (Director of Legal Education) and Devan Eaton (Public Interest Advocacy Fellow)
– The Anti-Fraud Coalition Members: Clay Wire (Ogborn Mihm), Kate Scanlan (Keller Grover), Rachel Rose (Rachel V. Rose – Attorney at Law), Nick Mendoza (Murphy Anderson), Max Voldman (Whistleblower Partners), Clark Bolton (Morgan & Morgan), Li Yu (Bernstein Litowitz Berger Grossman), Gina Poserina (Costello & Silverman), and Liz Soltan (Whistleblower Partners) for their contributions in writing and editing many of the posts in this project.
We hope you enjoy this year’s Fraud by the Numbers Series! Remember, numbers don’t lie; fraudsters do.
Jacklyn DeMar is the President & CEO of The Anti-Fraud Coalition.
[1] See DOJ press releases on Evolutions Flooring, Inc.; Global Plastics LLC; Grosfillex Inc.; and Allied Stone Inc.
