U.S. v. Inland Empire Health Plan Will Be Major Test for DOJ's FCA Theory based on Expenditure of Medicaid Adult Expansion Funds

• January 20, 2026

• Stefan Chacon , Hanson Bridgett LLP

After securing a number of settlements with California healthcare plans and providers in recent years related to the expenditure of Medicaid Adult Expansion funds, the United States faces a pivotal test of its theory under the False Claims Act in federal court later this month. In United States v. Inland Empire Health Plan (C.D. Cal. (9/17/25), Case No. 5:25-cv-02444) (complaint available at www.justice.gov/opa/media/1414371/dl), the United States alleges that Inland Empire Health Plan (IEHP), a county-based non-profit health plan in Southern California, violated the False Claims Act (FCA) by knowingly retaining excess funds it received under the Affordable Care Act's provisions expanding Medicaid coverage for low income adults.

ARTICLE TAGS

• Payers, Plans, and Managed Care Practice Group
• Fraud and Compliance
• Government Reimbursement