DOJ Mandates Accelerated Review of Benefits Fraud Qui Tams

On May 27, 2026, Assistant Attorney General Brett A. Shumate of the US Department of Justice’s Civil Division announced new guidelines to accelerate the investigation and prosecution of qui tams that allege fraud on federally-funded, state-administered benefits programs. AAG Shumate’s memorandum to all DOJ attorneys handling False Claims Act (FCA) cases, titled “Accelerating Review and Enhancing Enforcement in Benefits Fraud Matters” (the “Shumate Memo”), is DOJ’s latest pronouncement in the administration’s whole-of-government effort to combat fraud in federal programs. The new investigative framework laid out in the Shumate Memo has the potential to dramatically accelerate DOJ’s review of qui tams and increase the role of relators.

Accelerated Qui Tam Review

As a practical matter, the Shumate Memo aims to compress the time it takes for DOJ to investigate a new qui tam and decide whether to intervene. By law, the government has 60 days to review qui tam complaints and decide whether to intervene, but DOJ can move a court for an extension of time for good cause. 31 U.S.C. § 3730(b)(2)-(3). Courts frequently grant these motions, meaning that most qui tam actions that involve intervention or a settlement remain under seal for years.

Under the Shumate Memo’s new guidelines, DOJ attorneys must aim to complete their review of new benefits fraud qui tams within the statutory 60-day period but no later than 120 days. When that review period ends, the DOJ attorneys must make one of three decisions: (1) allow the relator to proceed as the primary litigant; (2) determine that further investigation is warranted; or (3) determine that the qui tam should be dismissed.

If the DOJ attorneys determine that further investigation is warranted, they must decide whether to intervene or decline within a 120-day “Investigative Period.” To extend that period another 120 days, they would need approval from the Deputy Assistant Attorney General of the Commercial Litigation Branch; any further extensions would require approval from the Assistant Attorney General of the Civil Division. These required internal DOJ approvals are in addition to the statutorily required extension of time from the relevant court.

Increased Role for Relators

The Shumate Memo also directs DOJ attorneys to better leverage relators and relator’s counsel to augment DOJ resources. The new guidelines encourage DOJ attorneys to consider allowing relator’s counsel to “promptly proceed to litigate” smaller but seemingly meritorious benefits fraud cases — for example, cases where (i) the facts alleged, if true, would constitute an FCA violation; (ii) the complaint alleges facts that are supported or corroborated by available evidence; (iii) the alleged misconduct is not novel or complex; (iv) the potential damages are below $10 million; and (v) aggravating factors, such as beneficiary harm or ongoing misuse of federal funds, are present.

The Shumate Memo acknowledges that this new protocol “will increase the number of benefits fraud matters primarily litigated by relators,” supplementing the government’s finite resources and allowing DOJ to concentrate on the “largest, most complex, and harmful fraud schemes.” Still, though relators and their counsel are advised to prepare to “shoulder the obligations of the litigation,” the Shumate Memo makes clear that any suit remains subject to DOJ “oversight and ultimate control of the matter” — including DOJ’s ongoing evaluation of the merits.

“Whole-of-Government” Approach

The Shumate Memo is also indicative of the administration’s continued focus on cross-government coordination in fraud enforcement. An outgrowth of Executive Order 14395, “Establishing the Task Force to Eliminate Fraud,” the Shumate Memo explains that DOJ will take a “whole-of-government approach to ensure that new benefits fraud matters receive accelerated review and evaluation for all available enforcement options.” It explains that new benefits fraud matters will be referred to the Criminal Division and/or National Fraud Enforcement Division (NFED) for evaluation of potential criminal violations and to the affected agency to evaluate for potential administrative action. Collaboration across government entities is not new to FCA enforcement, but the role of the NFED, which was recently established on April 7, 2026, is still to be seen.

Key Takeaways

The Shumate Memo is likely to speed some FCA investigations, but which ones is unclear. The Shumate Memo prescribes new guidelines for “benefits fraud” cases — i.e., cases involving fraud on “federally-funded benefits programs administered by states.” The Shumate Memo does not elaborate, but that mandate may be broad enough to cover an array of programs such as Medicaid, the Supplemental Nutrition Assistance Program, and other housing and cash assistance programs.

How DOJ attorneys will practically implement the Shumate Memo’s guidelines, particularly the accelerated review requirement, remains to be seen. But companies participating in these federal benefits programs should know that FCA enforcement is speeding up and becoming more relator-centric.

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The Goodwin Healthcare team will continue to monitor FCA enforcement developments and their potential impact on our clients. For more information on the issues discussed in this alert, please contact the authors or reach out to Goodwin’s Government Investigations, Enforcement & White Collar Defense group; or the False Claims Act group; or the Goodwin lawyer with whom you typically consult.

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