DOJ Launches FOCUS Initiative, Seeks Data Miners to Assist in Identifying and Building Fraud Claims
What You Need to Know
Key takeaway #1
The Department of Justice’s (DOJ) Fraud Oversight through Careful Use of Statistics (FOCUS) initiative reflects a new front in False Claims Act (FCA) enforcement, as civilian data miners — entities that analyze publicly available government data to identify potential fraud — have contributed to the significant uptick in complaints filed under the qui tam provisions of the FCA.Key takeaway #2
While the DOJ has acknowledged sophisticated data miners as valuable enforcement partners, FOCUS is structured to engage only the most analytically rigorous data miner relators, with the Department expressly seeking to filter out lower-quality filings that place undue strain on government resources.Key takeaway #3
Health care organizations and other government contractors should take the launch of FOCUS as a spur to audit their own claims and billing data, as publicly available information mined by external data miners may serve as the evidentiary foundation for qui tam complaints.
Client Alert | 5 min read | 05.05.26
On April 30, 2026, the DOJ announced the launch of the Fraud Oversight through Careful Use of Statistics initiative (FOCUS) to increase coordination between the Department and the growing host of data miners who sift through publicly available government data to identify patterns of alleged fraud. The launch of FOCUS highlights a growing trend in False Claims Act (FCA) enforcement: civilian data miners with access to public data — but no other connection to the alleged defendants — are filing almost as many qui tam complaints as company insiders.
Qui tam filings have risen sharply over the last several years; after filing a then-unprecedented 980 cases in 2024, relators tallied a total of 1,300 qui tam actions in 2025 and have, as of this writing, accounted more than 780 such actions so far for 2026, putting the Department on track for another record-breaking year. Notably, data miners have led almost half (45%) of all qui tam cases since fiscal year 2024. In its description of the FOCUS initiative, the DOJ notes that data miners have been particularly active in bringing cases alleging fraud on pandemic-relief programs. As we have previously discussed, some of these data miners are serial plaintiffs that have found success, whereas others have been defeated by challenges from defendants under the FCA’s public disclosure bar. Recent years have also seen data miners bring cases based on their analysis of a wide range of data sets — from claims data sourced from the Centers for Medicare and Medicaid Services to import entry data compiled by Customs and Border Protection.
The announcement of the FOCUS initiative signals that while data mining is here to stay, the DOJ wants to engage with these potential relators and their counsel to make sure that data miners are only bringing forth quality cases that merit the use of the DOJ’s investigative resources. Given FOCUS’ launch, the DOJ’s recent establishment of the National Fraud Enforcement Division, and the Trump Administration’s continued focus on what it terms “widespread waste, fraud, and abuse at the expense of the American taxpayer,” health care companies, government contractors, and others would be wise to review their own data as a compliance tool to identify and address issues that may be fodder for data miners.
DOJ Aims to Incorporate Data Miners into Enforcement Strategy
In this context, data miners are civilians, individuals, or companies who use advanced data analysis frameworks, strategies, and tools to parse large volumes of publicly available datasets for patterns that may signal potentially fraudulent behavior. Relators can use this information, once further contextualized with additional research, to support a formal complaint that a company has knowingly violated a specific contractual, statutory, or regulatory obligation. Moreover, the broad spread of artificial intelligence (AI) capabilities and other technological tools may inspire those the DOJ terms “new players in the space” to take it upon themselves to analyze public data in a hunt for fraud, in order to secure a share of any money recovered in qui tam litigation.
Data miners’ research is complementary to similar analytical efforts conducted by the DOJ — though the Department tends to narrow the scope of its internal review to non-public information collected by the government. As described by the DOJ in a document overviewing the FOCUS initiative, while “data miners generally do not provide insider information, the best data miners provide valuable leads through high-quality, reliable, and predictive data analyses and signals and a thorough understanding of the relevant legal obligations.”
The DOJ also acknowledges the potential for erroneous findings and that not all aspiring relators will be equally sophisticated. The Department’s interest is in ensuring “the effective use of enforcement resources” by strategically allocating its limited resources to advance “high-quality data miner qui tam actions.” To that end, the DOJ encourages civilian entities who have “demonstrated an investment in pre-filing diligence and commitment to analytical rigor, familiarity with program rules, and legally sufficient allegations” to discuss potential collaboration opportunities directly with FOCUS representatives.
The DOJ further advises data miners to focus on:
-
- Identifying a clear, material, and well-evidenced violation of a specific statutory, regulatory, or contractual obligation.
- Meeting the pleading standard laid out by Rule 9(b) of the Federal Rules of Civil Procedure, which requires plaintiffs who allege fraud to articulate factual circumstances indicating fraud with sufficient specificity.
- Vetting findings potentially indicative of fraud to rule out benign explanations for the observed patterns of behavior.
- Articulating how the data and other available evidence collectively suggest knowing misconduct (scienter) and falsity.
The launch of FOCUS indicates that DOJ will continue to leverage sound analysis methodologies to advance FCA enforcement — and will remain open to working with the public, and especially sophisticated data miners, in order to do so.
Implications for Health Care Organizations, Government Contractors, and Importers
The launch of FOCUS could have meaningful consequences for health care organizations, aerospace and defense companies, and other government contractors. By actively recruiting data miners who, in the Department’s words, “demonstrate an insightful application of sophisticated technological capabilities to regulatory frameworks to help identify potential fraud that would otherwise go undetected,” the DOJ aims to build an expanding network of sophisticated civilian enforcement partners. As FOCUS channels the most analytically rigorous relators toward viable cases, the likely result will be not simply more qui tam filings, but more that advance beyond the pleading stage. That shift, in turn, is likely to drive a corresponding uptick in government-initiated investigations opened on the strength of civilian leads.
As noted above, cases generated via this initiative could be impacted by the FCA public disclosure bar. If the DOJ declines intervention, and a relator’s case is found to be based solely on insights generated from publicly available data published by the government without any additional insider information, the data-miner's complaint may be vulnerable to being dismissed under the public disclosure bar unless the government uses its statutory authority to oppose such a dismissal. It remains to be seen whether the FOCUS initiative will lead to a higher intervention rate in quality cases brought by data-miners or whether DOJ will be more active in utilizing its authority to block dismissal on public disclosure grounds.
Health care organizations, among others, should strongly consider developing a proactive strategy to understand the potential FCA exposure in their own data. Given that the data that external miners are scanning is data that health care entities already possess internally, organizations may benefit from conducting regular, rigorous audits of their own claims, billing, and government-reported data — both to identify compliance gaps and to understand how sophisticated data miners might attempt to build a qui tam complaint. A sound compliance program should account for the possibility that the next adverse enforcement action originates not from an insider, but from a public dataset.
Contacts
Insights
Client Alert | 3 min read | 04.14.26
On Friday, April 10, 2026, the U.S. Department of Justice (DOJ) announced that International Business Machines Corporation (IBM) has agreed to pay just over $17 million to resolve allegations that it violated the False Claims Act (FCA) by failing to comply with federal anti-discrimination requirements incorporated into its federal contracts due to allegedly discriminatory diversity, equity, and inclusion (DEI) employment practices. This resolution marks the first FCA settlement secured by the DOJ under its Civil Rights Fraud Initiative, created in May 2025, and announced by then-Deputy Attorney General Todd Blanche as part of the administration’s coordinated efforts to target allegedly unlawful DEI practices. Per the agreement, the settlement is neither an admission of liability by IBM nor a concession by the United States that its claims are not well founded.
Client Alert | 4 min read | 04.16.26
ROI Tracking as Mens Rea? Novartis Ruling Reframes AKS Pleading Risk
Publication | 04.24.26
Medicaid Plan M&A: Navigating an Increasingly Complex State Environment
Client Alert | 6 min read | 04.29.26
CMS Seeks to Expand Interoperability Requirements to Drug Pre-Authorization (FAQ)





