On January 16, the U.S. Department of Justice (DOJ) released its annual report on civil fraud recoveries (settlements and judgments) for FY2025, along with a press release highlighting DOJ’s civil enforcement efforts. 

Our key observations from DOJ’s release include:

1. Total Recoveries Set All-Time Record.  In our observations of DOJ’s announced results for FY2024, which included the fourth-lowest total recovery since 2010, we noted that FY2025 was off to a strong start with two settlements totaling more than $850 million announced late in 2024.  That strong start set the pace for a record-setting year, with DOJ announcing settlements and judgments of nearly $6.9 billion, eclipsing its prior record by more than $700 million and more than doubling its recoveries from last year.  
2. Recoveries Paced by Rare FCA Trial Outcomes.  There were an atypical number of high-dollar judgments following relatively rare False Claims Act (FCA) trials last year, including a $948.8 million judgment against Omnicare, a $290 million judgment against CVS Caremark, and a more than $1.6 billion judgment against Janssen Pharmaceuticals.  Each of those judgments is on appeal with arguments and rulings expected later this year, so it is far from certain whether the record-setting numbers for FY2025 will remain intact. 
3. Healthcare Industry-Related Recoveries Reverse Downward Trend.  After several years in which annual recoveries involving the healthcare industry remained below $2 billion, last year’s recoveries involving the healthcare industry hit an all-time high of more than $5.7 billion.  Those recoveries were led by the judgments and settlements referenced above, which all involved the healthcare industry.   
4. Percentage of Total Recoveries Involving the Healthcare Industry Returned to Historic Levels.  In FY2024, FCA recoveries involving the healthcare industry amounted to only 57.3% of the total recoveries—a significant drop from the roughly 80% level at which healthcare recoveries have historically hovered.  For FY2025, recoveries involving the healthcare industry rebounded to 83%.       
5. Number of Newly-Filed Qui Tam Lawsuits Smashes Prior Record (Again).  We noted last year that the 979 qui tam lawsuits filed in FY2024 smashed prior records.  That record didn’t last long, as an astonishing 1,297 qui tam lawsuits were filed in FY2025.  Including the record-setting totals from the last two years, there have been more than 4,200 qui tam lawsuits filed in the last five years.  No doubt DOJ has its hands full in investigating the allegations associated with those lawsuits, as it is statutorily obligated to do under the FCA. 
6. Recoveries Stemming from Qui Tam Lawsuits Remain High.  Given the substantial number of qui tam lawsuits filed each fiscal year, it comes as no surprise that recoveries stemming from such lawsuits continue to drive overall civil fraud recoveries.  The record setting year also included the highest dollar amount of recoveries ever associated with matters initiated by the filing of qui tam lawsuits ($5.34 billion), which reflected 77% of total recoveries.
7. Percentage of Qui Tam Lawsuits Involving Healthcare Industry Continues Downward Trend.  We have previously noted the trend of the declining number of qui tam lawsuits involving the healthcare industry.  For FY2025, the total number of new qui tam lawsuits involving the healthcare industry increased to 458 lawsuits, up significantly from the 370 such lawsuits filed in FY2024.  As a percentage of total qui tam lawsuits, however, the downward trend continued.  Qui tam lawsuits involving the healthcare industry comprised only 35% of the total lawsuits filed last year, which was down significantly from the average percentage over the last five years (53%).  The numbers also show that nearly 800 new qui tam lawsuits did not involve the healthcare or defense industries and very likely involve alleged FCA violations associated with pandemic relief.    
8. Large Judgment Drives Record-Setting Recoveries in Declined Healthcare Qui Tam Matters.  In FY2024, the total share of settlements and judgments relators obtained from qui tam actions involving federal healthcare programs where DOJ declined to intervene was one of the lowest totals in recent years.  For FY2025, however, the $1.6 billion judgment against Janssen contributed to the highest ever recoveries associated with matters initiated by the filing of qui tam lawsuits, but where the United States declined to intervene (nearly $2.3 billion).
9. Relator Share Awards.  Under the FCA, relators are entitled to a percentage share of a judgment or settlement, which provides the financial incentive for whistleblowers to bring qui tam lawsuits.  Although DOJ announced a record-setting year of FCA recoveries in matters arising from qui tam lawsuits, relator share awards amounted to only $330 million, well below the 10-year average of $438 million.  This disparity is almost certainly the result of the fact that relator shares have not yet been awarded in matters where judgments totaling over $2.8 billion remain pending on appeal.              
10. Non-Qui Tam Matters.  In recent years, DOJ has touted the number of new non-qui tam matters, which have reflected the highest number of FCA matters initiated by DOJ since the 1986 FCA amendments.  A significant number of those matters, however, involved consent judgments and small-dollar recoveries stemming from false claims associated with the pandemic-related Paycheck Protection Program (PPP).  In FY2025, DOJ announced more than 400 new non-qui tam matters, which is a number that remains consistent with totals from the last five years (and is the third highest number since the 1986 FCA amendments).  What stood out about that announcement, however, was the fact that 183 of those matters involved the healthcare industry, which was nearly 100 more new matters involving the healthcare industry than had been reported in FY2024. 
11. MA/Pharma, AKS & Medical Necessity.  Among the key healthcare-related settlements, significant areas of focus remained the Medicare Advantage (MA) and pharmaceutical sectors of the healthcare industry, along with matters involving alleged violations of the Anti-Kickback Statute (AKS) and medically unnecessary services.  We will cover each of these areas of focus, along with nearly every other FCA settlement from 2025, in our Healthcare Fraud & Abuse Year in Review settlement chart. 

Be on the lookout for our 14th annual Healthcare Fraud & Abuse Review, which will be released in the coming weeks.  In the Review, we will provide a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the FCA, and an overview of settlements involving fraud and abuse issues.