What DOJ’s FOCUS initiative means for statistical evidence in False Claims Act matters.

What is the DOJ FOCUS initiative?

A framework for how the Civil Division will work with relators whose cases come from public data.

On April 30, 2026, the Department of Justice’s Civil Division announced the Fraud Oversight through Careful Use of Statistics initiative, FOCUS.1 It is addressed to “data miners,” DOJ’s term for those who “analyze publicly available government data for potential signals of fraud” rather than relying on insider knowledge.2

FOCUS supports DOJ’s National Fraud Enforcement Division, created on April 7, 2026. The initiative document says what DOJ values in a data-driven complaint: the “insightful application of sophisticated technological capabilities to regulatory frameworks,” and “investment in pre-filing diligence and commitment to analytical rigor.”

Noting that “advanced agentic and AI capabilities” allow new players into the field, DOJ welcomes established and new data miners alike. A meeting is optional. DOJ states that such meetings “are not a pre-filing requirement.”

Why is DOJ asking more of data miners?

Volume and yield. DOJ reports that since fiscal year 2024, data miners have filed more than 45% of all qui tam complaints.2 It also notes that approximately 22% of all qui tams were pursued by the government, and that the most successful relators have traditionally supplied a “cogent investigative roadmap” of facts to corroborate, witnesses to interview and evidence to obtain.

DOJ points to the pandemic-loan record as a caution. There, more than three-quarters of settlements and judgments came from cases DOJ initiated itself, “suggesting a lower overall success rate” for data-miner complaints.

The initiative document is direct about what it expects. Data miners should be “mindful of the heightened pleading standard of Rule 9(b),” should “assess potential alternative explanations for the observed conduct,” and should present facts that suggest “both scienter and falsity.” It urges them to “partner with others who can aid their understanding of program eligibility requirements.” In announcing FOCUS, DOJ said participants should explain “how they validate their findings.”1

What does the FOCUS white paper questionnaire ask for?

On July 17, 2026, DOJ updated its announcement with a FOCUS white paper questionnaire.3 The submission is a paper of no more than 10 pages. It asks the relator to set out:

• The fraud type, the federal program and the geographic scope at issue.
• The specific datasets used, by name.
• The model’s assumptions.
• Subject-matter experts consulted.
• How accuracy was tested, and whether external information corroborates the results.
• The governing statutes and regulations.
• Legitimate alternative explanations for the pattern.
• The single best example of fraud, “as opposed to an administrative overpayment,” with estimated single damages.
• Prior qui tams filed by the relator.
• Any financial ties to the industry analyzed.
• The submitter’s background and credentials.

The questionnaire states the standard in one line: “a data signal with a reasonably strong correlation to potential fraud.” In our reading, a signal that mainly tracks size, specialty or documentation practice would struggle to meet it.

Can statistics alone support a False Claims Act complaint?

Two appellate decisions involving the same data-analytics relator frame the answer. Both ended in dismissal, and both left room for statistics paired with particular details.

Fifth Circuit: Integra v. Baylor Scott & White (2020)

The relator used CMS data to show the hospital system coded major complications and comorbidities more often than peers. The Fifth Circuit affirmed dismissal. The statistics were equally consistent with the system lawfully running ahead of the industry after CMS’s 2007 coding changes, “consistent with a legal and obvious alternative explanation.”4 The complaint’s examples did not help: “No example gives any indication about what makes it a false claim.” The court added that its ruling “does not exclude statistical data from being used to meet the pleading requirements” when the statistics are paired with particular details. The Supreme Court denied certiorari on December 7, 2020 (No. 20-581).5

Ninth Circuit: Integra v. Providence (2021)

Here the relator showed a health system coded three major complications about 1.7 times as often as peers, controlled for demographics and reported less than a one-thousandth percent chance that the difference was due to chance. The Ninth Circuit still ordered dismissal under Rule 8, because the “allegations do not eliminate an obvious alternative explanation.”6 The court relied on CMS’s position that coding to maximize payment is not wrong when it is “supported by documentation in the medical record.” It also said its holding “does not categorically preclude statistical data.”

Statistics are a starting point. The complaints that failed had no facts excluding the lawful explanation.Marque Analytics reading of the two Integra decisions

What corroboration looks like

The Fifth Circuit pointed to a contrast case. In U.S. ex rel. Customs Fraud Investigations v. Victaulic Co. (3d Cir. 2016), statistics were paired with an expert declaration, photographs, a witness and shipment records.4

Two more decisions worth knowing

In Health Choice Alliance v. Eli Lilly (5th Cir. 2021), the court affirmed DOJ’s dismissal under § 3730(c)(2)(A) of suits filed by entities created to file qui tams.7 Those relators were professional-relator entities rather than pure data miners. Two years later the Supreme Court set the standard for that dismissal power in United States ex rel. Polansky v. Executive Health Resources, Inc., 599 U.S. 419 (2023): the government may move to dismiss whenever it has intervened, during the seal period or later on a showing of good cause, and courts apply the Rule 41(a) standard for voluntary dismissals.9 In U.S. ex rel. Relator, LLC v. Erskine, a published opinion of July 15, 2026 (No. 25-2073), the Ninth Circuit held the public disclosure bar did not apply to the relator’s pandemic-loan eligibility theory (assuming without deciding that PandemicOversight.gov is a federal report), because the pleaded facts were not “substantially the same” as the public data. It agreed the separate employee-headcount theory was not plausibly pleaded but held leave to amend should have been granted. It reversed and remanded, leaving the relator’s other theories to the district court.8

Questions to ask of a data-driven allegation

The questionnaire and the case law point the same way. The list below gathers them as questions counsel can put to any data-driven allegation. It is a working aid, not a legal standard, and counsel decides what a matter needs.

Where analytical support fits

Most of the questionnaire is about the analysis: named datasets, stated assumptions, accuracy testing, alternative explanations and a best example with damages. That is work counsel can retain. Marque provides entity resolution, forensic cross-referencing and analytical packages, prepared at the direction of counsel, with the method laid out for expert review.

Marque is not a law firm and gives no legal advice. More on how we work with counsel is on the litigation support page.

Sources and how this note was prepared

1. 1U.S. Department of Justice, Civil Division Announces FOCUS Initiative, press release, April 30, 2026, updated July 17, 2026.
2. 2U.S. Department of Justice, Civil Division, Fraud Oversight through Careful Use of Statistics (FOCUS) initiative, April 30, 2026.
3. 3U.S. Department of Justice, FOCUS White Paper Questionnaire (PDF), July 17, 2026, linked from the updated press release in note 1; see also the copy hosted by Sidley Austin and Sidley, DOJ Releases FOCUS Questionnaire, July 20, 2026.
4. 4U.S. ex rel. Integra Med Analytics, L.L.C. v. Baylor Scott & White Health, No. 19-50818, 816 F. App’x 892 (5th Cir. May 28, 2020) (per curiam, unpublished), slip opinion; Victaulic is discussed at n.19.
5. 5Supreme Court of the United States, docket No. 20-581, certiorari denied December 7, 2020; see also Jones Day, Supreme Court Leaves Fifth Circuit False Claims Act Ruling Intact, January 2021 (No. 20-581).
6. 6Integra Med Analytics LLC v. Providence Health & Services, No. 19-56367 (9th Cir. Mar. 31, 2021) (memorandum, unpublished), memorandum; citing 72 Fed. Reg. 47,180.
7. 7U.S. ex rel. Health Choice Alliance, L.L.C. v. Eli Lilly & Co., 4 F.4th 255 (5th Cir. July 7, 2021), No. 19-40906, opinion.
8. 8U.S. ex rel. Relator, LLC v. Erskine, No. 25-2073 (9th Cir. July 15, 2026) (published), opinion.
9. 9United States ex rel. Polansky v. Executive Health Resources, Inc., 599 U.S. 419 (June 16, 2023), No. 21-1052, opinion.

Questions