Polsinelli proudly introduces its Fraud and Abuse: Recent Trends, Key Developments and What’s Next e-book. This publication is intended to serve as a valuable resource for health care industry stakeholders, aiming to equip you with insight into the past year’s happenings in order to better navigate the complex landscape of health care fraud and abuse enforcement. Drawing upon the decades of experience that Polsinelli’s government investigations team has in defending False Claims Act cases and health care government investigations, we curated the most notable settlements, court decisions and guidance from regulators in 2025.

Key Takeaways Courts Revisit the Constitutionality of the FCA: Recent federal decisions reflect renewed judicial scrutiny of the False Claims Act’s qui tam provisions, which authorize private individuals to bring enforcement actions on behalf of the United States. Federal judges call for Supreme Court review of FCA qui tam provisions: A district court ruling and a Fifth Circuit concurrence both urge reconsideration of prior precedent, citing separation-of-powers concerns under Article II. Potential circuit split may prompt broader change in FCA enforcement: If the Eleventh Circuit affirms the Zafirov decision, the issue could head to the Supreme Court and reshape whistleblower-driven enforcement across regulated industries. Background The False Claims Act (FCA) allows private citizens (relators) to file suits on behalf of the United States against entities