DOJ Gives Massachusetts Health Care Enforcement a Booster Shot

Reflecting the Department of Justice’s (DOJ) continued focus on health care fraud, the District of Massachusetts’ already robust Health Care Fraud Unit is set to get even stronger. On 23 September 2025, the DOJ’s Criminal Division announced it is expanding the Health Care Fraud Unit’s New England Strike Force (the Strike Force) to the District of Massachusetts.

In making the announcement, DOJ emphasized that Massachusetts is one of the country’s “most significant” health care and life sciences hubs and the expansion of the Strike Force will act as a “force multiplier” to provide additional resources to investigate and prosecute health care fraud.¹  

What is the Strike Force? 

The Health Care Fraud Unit’s Strike Forces are specialized interagency enforcement teams dedicated to investigating and prosecuting complex fraud schemes impacting the health care market. Strike Force operations have expanded since first launched in 2007 to cover various geographic regions and subject areas. 

The New England Strike Force, which previously collaborated with US Attorneys’ offices in the Districts of Maine, New Hampshire, and Vermont, focuses on civil and criminal fraud—including Medicaid/Medicare fraud, False Claims Act and Anti-Kickback Statute violations, money laundering, wire and mail fraud, and illegal prescriptions of controlled substances. Past targets have included pharmaceutical companies, medical device manufacturers, medical practitioners, and health care company corporate executives.  

What Does It Mean for Massachusetts?

The District of Massachusetts is no stranger to health care enforcement; the office last year brought more than 20 actions and maintains a robust slate of prosecutors. But the expansion of the Strike Force to Massachusetts brings new tools to detect fraud through interagency collaboration, data analytics, and tracing of funds. The Strike Force is likely to promote faster investigations, while identifying more sophisticated fraud schemes that may otherwise go uncovered.  

Focus on Corporate Accountability 

In line with the DOJ’s increased focus on corporate accountability, the Strike Force expansion is expected to provide helpful tools for the DOJ to further target health care companies and their executives who engage in systemic fraudulent conduct. Recent examples of corporate actions brought by the Health Care Fraud Unit include: 

• US$1.018 million settlement with a pharmacy to resolve alleged False Claims Act violations related to claims that the pharmacy completed prior authorization forms for prescriptions in place of prescribing physicians and submitted forms that contained false information.²   
• US$40.4 million settlement with a consumer goods company to resolve criminal charges for introducing adulterated surgical gowns into interstate commerce, with an intent to defraud and mislead.³  
• US$1.43 million settlement with an insurance company relating to the use of artificial intelligence and automation software to obtain Medicare beneficiary information and fraudulently enroll beneficiaries into its Medicare Advantage plans.⁴  

The New England Strike Force also recently supported Operation Gold Rush, a nationwide investigation against 19 defendants in connection with US$10.6 billion in fraudulent Medicare claims, the largest loss amount ever charged in a health care fraud case brought by the DOJ.⁵ The transnational criminal organization implicated in this investigation allegedly purchased dozens of medical equipment companies and submitted billions of dollars in false and fraudulent health care claims to Medicare. 

Takeaways

While the District of Massachusetts has historically had a robust health care fraud division, the expansion of the Health Care Fraud Unit’s New England Strike Force to Massachusetts aligns with the DOJ’s 2025 enforcement priorities,⁶ which included targeting fraud, waste, and abuse in the health care sector. Companies and executives in the health care space can expect to see accelerated detection and investigation into fraud, a focus on data-driven investigations, and multi-agency cooperation.