The Department of Justice (DOJ) is changing how it handles health care enforcement under the Trump administration. With new leaders and a shift in focus, the DOJ is tweaking its approach to traditional fraud cases while introducing more politically-driven priorities.
Key Points of Change
Leadership Changes: In 2025, the DOJ saw a wave of departures among senior leaders, raising doubts about the agency’s ability to tackle ongoing fraud cases. One-third of the experienced staff left, marking a significant shakeup. Michael Granston, a long-time leader known for his fair approach, is no longer overseeing False Claims Act (FCA) cases, with responsibility shifting to Brenna Jenny.
Shifting Enforcement Priorities: Recent memos indicate that the DOJ plans to focus not just on traditional areas like Medicare fraud but also on politically charged issues, such as gender-affirming care. This represents a notable change in how the DOJ operates.
Core Fraud Enforcement Strength: Despite these changes, the DOJ is still committed to pursuing long-established fraud schemes related to opioids, telemedicine, and Medicare Advantage.
A Bumpy Road Ahead: With mixed political priorities and ongoing staffing issues, 2026 is expected to be unpredictable regarding health care enforcement.
Details on Key Personnel Changes
Since January 2025, the DOJ has lost numerous experienced attorneys, impacting its capacity to handle ongoing FCA cases. This trend raises concerns about potential increases in case dismissals. Notably, Christi Grimm, Inspector General for HHS, was removed from her position, an expected move given past tensions with the administration.
Changes in Enforcement Focus
The DOJ is now emphasizing transparency and is more vocal about its enforcement priorities. In May 2025, Matthew Galeotti outlined a focus on healthcare fraud alongside self-disclosure policies in his memo. In June, Brett Shumate’s memo hinted at a shift from the DOJ’s traditional independence, indicating a more politically motivated focus.
Unusual Developments in Enforcement
The DOJ’s approach has taken some unexpected turns. For instance, in July 2025, it issued more than 20 subpoenas targeting providers involved in gender-affirming care, a move that is unusual and sparks debate. These actions could raise questions about how the DOJ balances public health imperatives with political objectives.
Conclusion
The recent shifts in DOJ leadership and enforcement focus suggest a significant departure from traditional practices. As political priorities enter the mix, we may see a variety of enforcement actions that challenge existing legal and ethical frameworks, making future outcomes uncertain.
For further insights on health care enforcement trends, you can explore more on the Mintz Insights Center.
