More Than 300 Charged in Record $14.6B Healthcare Fraud Takedown

State and federal prosecutors have charged 324 people and uncovered nearly $15 billion in false insurance claims in a takedown of the largest coordinated healthcare fraud scheme in U.S. Justice Department history.

The DOJ—through its 2025 National Health Care Fraud Takedown—filed criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged roles in various schemes to defraud the healthcare industry (and U.S. government) of more than $14.6 billion.

“This record-setting Health Care Fraud Takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” said Attorney General Pamela Bondi. “Make no mistake—this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”

The U.S. government seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets in breaking up the fraudulent schemes. As part of the whole-of-government approach to combating healthcare fraud, the Centers for Medicare and Medicaid Services (CMS) announced that it prevented the payout of more than $4 billion in false claims and that it suspended or revoked the billing privileges of 205 providers in the months leading up to the Takedown. Civil charges against 20 defendants for $14.2 million in alleged fraud, as well as civil settlements with 106 defendants totaling $34.3 million, were also announced as part of the Takedown.

The Takedown was led and coordinated by the Health Care Fraud Unit of the Justice Department’s Criminal Division’s Fraud Section and its core partners from U.S. Attorneys’ Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), the FBI, and the Drug Enforcement Administration (DEA). The cases were investigated by agents from HHS-OIG, FBI, DEA, and other federal and state law enforcement agencies. The cases are being prosecuted by Health Care Fraud Strike Force teams from the Criminal Division’s Fraud Section, 50 U.S. Attorneys’ Offices nationwide, and 12 State Attorneys General Offices.

“The Criminal Division is intensely committed to rooting out healthcare fraud schemes and prosecuting the criminals who perpetrate them because these schemes: (1) often result in physical patient harm through medically unnecessary treatments or failure to provide the correct treatments; (2) contribute to our nationwide opioid epidemic and exacerbate controlled substance addiction; and (3) do all of that while stealing money hardworking Americans contribute to pay for the care of their elders and other vulnerable citizens,” said Matthew R. Galeotti, head of the Justice Department’s Criminal Division. “The Division’s Health Care Fraud Unit and U.S. Attorneys’ Offices stand united with our law enforcement partners in this fight, and we will continue to use every tool at our disposal to protect the integrity of our health care programs for the American people.”

“As part of making healthcare accessible and affordable to all Americans, HHS will aggressively work with our law enforcement partners to eliminate the pervasive health care fraud that bedeviled this agency under the former administration and drove up costs,” added Secretary Robert F. Kennedy Jr. of the Department of Health and Human Services.

Transnational Criminal Organizations

Authorities charged 29 defendants for their respective roles in transnational criminal organizations that allegedly submitted more than $12 billion in fraudulent claims to America’s health insurance programs.

For instance, a nationwide investigation called Operation Gold Rush resulted in the largest loss amount ever charged in a healthcare fraud case brought by the DOJ. The charges were announced in the Eastern District of New York, the Northern District of Illinois, the Central District of California, the Middle District of Florida, and the District of New Jersey against 19 defendants. Twelve of these defendants have been arrested, including four who were apprehended in Estonia as a result of international cooperation with Estonian law enforcement and seven who were taken into custody at U.S. airports and the U.S. border with Mexico before they left the country.

The organization allegedly used a network of foreign straw owners, including individuals sent into the United States from abroad, who, acting at the direction of others using encrypted messaging and assumed identities from overseas, strategically bought dozens of U.S.-based medical supply companies. They then quickly submitted $10.6 billion in fraudulent healthcare claims to Medicare for urinary catheters and other durable medical equipment by exploiting the stolen identities of more than 1 million Americans spanning all 50 states and using their confidential medical information to submit the false claims. As alleged, the organization exploited the U.S. financial system by laundering the fraudulent proceeds and deploying a range of tactics to circumvent anti-money laundering controls to transfer funds into cryptocurrency and shell companies located abroad. Among the arrested was a banker who facilitated the money laundering on behalf of the organization through a U.S.-based bank.

The Health Care Fraud Unit’s Data Analytics Team and its partners detected the anomalous billing through proactive data analytics, and HHS-OIG and CMS successfully prevented the organization from receiving all but approximately $41 million of the approximately $4.45 billion that was scheduled to be paid by Medicare. HHS and CMS intend to seek to return the $4.41 billion in escrow to the Medicare trust fund for needed medical care. The scheme nonetheless resulted in payments of approximately $900 million from Medicare supplemental insurers. To date, law enforcement has seized approximately $27.7 million in fraud proceeds as part of Operation Gold Rush.

“Healthcare fraud drains critical resources from programs intended to help people who truly need medical care,” FBI Director Kash Patel stated. “This announcement demonstrates our commitment to pursuing those who exploit the system for personal gain. With more than $13 billion in fraud uncovered, this is the largest takedown for this initiative to date. Together, the FBI and our law enforcement partners will continue to hold those accountable who steal from the American people and undermine our healthcare systems.”

Prosecutors in the Northern District of Illinois disrupted a $703 million insurance fraud scheme, filing charges against five defendants—including two owners and executives of Pakistani marketing organizations—who allegedly stole Medicare beneficiaries’ identification numbers and other confidential health information. The defendants allegedly used artificial intelligence to create fake recordings of Medicare beneficiaries purportedly consenting to receive certain products. According to court documents, the beneficiaries’ confidential information was then illegally sold to laboratories and durable medical equipment companies, which used this unlawfully obtained and fraudulently generated data to submit false Medicare claims. Certain defendants controlled dozens of nominee-owned durable medical equipment companies and laboratories that allegedly submitted false claims for products and services the beneficiaries did not request, need, or receive. Certain defendants also allegedly conspired to conceal and launder the fraud proceeds from bank accounts they controlled in the United States to overseas accounts. In total, the defendants submitted approximately $703 million in false claims to Medicare and Medicare Advantage plans, which paid approximately $418 million on those claims. The government seized approximately $44.7 million from various bank accounts related to this case.

“The scale of today’s Takedown is unprecedented, and so is the harm we’re confronting. Individuals who attempt to steal from the federal health care system and put vulnerable patients at risk will be held accountable,” said Acting Inspector General Juliet T. Hodgkins of HHS-OIG. “Our agents at HHS-OIG work relentlessly to detect, investigate, and dismantle these fraud schemes.”

Finally, a defendant based in Pakistan and the United Arab Emirates who owned a billing company allegedly orchestrated a scheme to prey upon vulnerable individuals in need of addiction treatment by conspiring with treatment center owners to fraudulently bill Arizona Medicaid approximately $650 million for substance abuse treatment services. According to court documents, some of the services billed were never provided, while other services were provided at a level that was so substandard that it failed to serve any treatment purpose. As part of the conspiracy, treatment center owners allegedly paid illegal kickbacks in exchange for patient referrals recruited from the homeless population and Native American reservations. The defendant received at least $25 million of ill-gotten Arizona Medicaid funds as a result of the conspiracy and is charged with a money laundering offense for his alleged use of those funds to purchase a $2.9 million home located on a Dubai golf estate.

Fraudulent Wound Care

Prosecutors in Arizona and Nevada filed charges against seven defendants, including five medical professionals, in connection with roughly $1.1 billion in fraudulent claims to Medicare and other health care benefit programs for amniotic wound allografts. Certain defendants allegedly targeted vulnerable elderly patients, many of whom were receiving hospice care, and applied medically unnecessary amniotic allografts to these patients’ wounds. Authorities said many of the allografts reportedly were applied without coordination with the patients’ treating physicians, without proper treatment for infection, to superficial wounds that did not need the treatment, and to areas that far exceeded the wound’s sized. Certain participants allegedly received millions of dollars in illegal kickbacks from the fraudulent billing scheme.

“This unprecedented enforcement action demonstrates that CMS and our federal partners are united in our mission to protect the integrity of Medicare and Medicaid by crushing waste, fraud, and abuse,” said CMS Administrator Dr. Mehmet Oz. “Every dollar we prevent from going to fraudsters is a dollar that stays in the system to serve legitimate beneficiaries. Through advanced data analytics, real-time monitoring, and swift administrative action, CMS is leading the fight to protect Medicare, Medicaid, and the trust Americans place in these vital programs. We’re not waiting for fraud to happen—we’re stopping it before it starts.”

Prescription Opioid Trafficking

Seventy-four defendants, including 44 licensed medical professionals, were charged across 58 cases in connection with the alleged illegal diversion of more than 15 million prescription opioids and other controlled substances. Five defendants associated with one Texas pharmacy were charged with the unlawful distribution of more than 3 million opioid pills. Authorities claim the defendants conspired to distribute massive quantities of oxycodone, hydrocodone, and carisoprodol, which were subsequently trafficked by street-level drug dealers, generating large profits for the defendants. This coordinated action is a continuation of the Health Care Fraud Unit’s systematic approach to stopping drug trafficking organizations and their pharmaceutical wholesale suppliers, which together have fueled an epidemic of prescription opioid abuse for nearly a decade.

In the last six months, the DEA charged 93 administrative cases seeking to revoke pharmacies’, medical practitioners’, and companies’ authority to handle and/or prescribe controlled substances.

“Healthcare fraud isn’t just theft—it’s trafficking in trust. This announcement shows that when doctors become drug dealers and treatment centers become profit-driven fraud rings, DEA will act,” Acting DEA Administrator Robert Murphy said. “We’re targeting the entire ecosystem of fraud, from pill mills in Texas to kickback clinics exploiting Native communities. If you abuse your medical license to push poison or pad your pockets, we will hold you accountable.”

Telemedicine and Genetic Testing Fraud

The Takedown included 49 defendants charged with submitting more than $1.17 billion in alleged false Medicare claims for telemedicine and genetic testing fraud schemes. In the Southern District of Florida, prosecutors charged an owner of telemedicine and durable medical equipment companies with a $46 million scheme that targeted Medicare beneficiaries through deceptive telemarketing campaigns. The owner then submitted those fraudulent claims to Medicare for durable medical equipment and genetic tests for the beneficiaries, prosecutors contended. The Department continues to focus on eliminating healthcare fraud schemes that depend on telemedicine, including schemes involving fraudulent claims for genetic testing, durable medical equipment, and COVID-19 tests.

An additional 170 defendants are being charged for their roles in healthcare fraud schemes involving more than $1.84 billion in alleged false claims to Medicare, Medicaid, and private insurance companies for diagnostic testing, medical visits, and treatments that were medically unnecessary, provided in connection with kickbacks and bribes, or never provided at all. For example, in the Western District of Tennessee, prosecutors charged three defendants, including business owners and a pharmacist, with a $28.7 million scheme to defraud the Federal Employees’ Compensation Fund by allegedly billing for medications for injured U.S. Postal Service employees that were never prescribed by a licensed practitioner and largely were not dispensed as claimed. And in the Western District of Washington and the Northern District of California, prosecutors charged medical providers with allegedly stealing fentanyl and hydrocodone, respectively, that was meant for the providers’ patients, including child patients needing anesthesia.

“VA’s Integrated Veteran Care Programs provide critical community-based health care to our nation’s disabled veterans and their dependents,” said Acting Inspector General David Case of the Department of Veterans Affairs Office of Inspector General (VA-OIG). “Robust oversight of VA’s health care system is one of VA-OIG’s highest priorities. VA-OIG is committed to holding accountable those who defraud government benefits programs intended to care for our nation’s heroes.”

In connection with the coordinated nationwide law enforcement operation, the Department is working closely with HHS-OIG, FBI, and other agencies to create a Health Care Fraud Data Fusion Center to bring together experts from the Department’s Criminal Division, Fraud Section, Health Care Fraud Unit Data Analytics Team; HHS-OIG; FBI; and other agencies to leverage cloud computing, artificial intelligence, and advanced analytics to identify emerging healthcare fraud schemes. The Health Care Fraud Unit’s Data Analytics Team was established in 2018 to enhance the Unit’s ability to detect, investigate, and prosecute complex healthcare fraud schemes. Joining forces with data analysts from HHS-OIG, FBI, and other partners will increase efficiency, detection, and rapid prosecution of emerging healthcare fraud schemes. It will also implement the President’s Executive Order Stopping Waste, Fraud, and Abuse by Eliminating Information Silos (Exec. Order No. 14243, 3 C.F.R. 294 (2025)) by reducing duplicative data teams, increasing operational efficiency through a whole-of-government approach, and leveraging cloud computing, artificial intelligence, and other agency resources.

Principal Assistant Deputy Chief Jacob Foster, Assistant Deputy Chief Rebecca Yuan, Trial Attorney Miriam L. Glaser Dauermann, and Data Analyst Elizabeth Nolte, all of the Health Care Fraud Unit of the Criminal Division’s Fraud Section, led and coordinated this year’s Takedown. The cases are being prosecuted by the Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, New England, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Columbia, District of Connecticut, District of Delaware, Middle District of Florida, Northern District of Florida, Southern District of Florida, Middle District of Georgia, District of Idaho, Northern District of Illinois, Eastern District of Kentucky, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of Maine, District of Massachusetts, Eastern District of Michigan, Western District of Michigan, Northern District of Mississippi, Southern District of Mississippi, District of Montana, District of Nevada, District of New Hampshire, District of New Jersey, Eastern District of New York, Northern District of New York, Southern District of New York, Western District of New York, Eastern District of North Carolina, Western District of North Carolina, District of North Dakota, Northern District of Ohio, Southern District of Ohio, Northern District of Oklahoma, Western District of Oklahoma, District of Oregon, Eastern District of Pennsylvania, District of South Carolina, Middle District of Tennessee, Western District of Tennessee, Northern District of Texas, Southern District of Texas, Western District of Texas, District of Vermont, Eastern District of Virginia, Western District of Washington, and Northern District of West Virginia; and State Attorneys General’s Offices for California, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Missouri, New York, Ohio, Pennsylvania, South Carolina, and Wisconsin. The Health Care Fraud Unit’s Data Analytics Team used cutting-edge data analytics to identify and support the investigations that led to these charges.

In addition to FBI, HHS-OIG, DEA, and CMS, HSI, VA-OIG, IRS Criminal Investigation, Defense Criminal Investigative Service, Department of Labor, United States Postal Service Office of Inspector General, Office of Personnel Management Office of Inspector General, and other federal, state, and local law enforcement agencies participated in the operation. The Medicaid Fraud Control Units of California, the District of Columbia, Florida, Georgia, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Missouri, New York, North Carolina, North Dakota, Ohio, Pennsylvania, South Carolina, Texas, Virginia, and Wisconsin also participated in the investigation of many of the federal and state cases announced today.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Forces. Prior to the charges announced as part of the nationwide Takedown and since its inception in March 2007, the Health Care Fraud Strike Force, which operates in 27 districts, charged more than 5,400 defendants who collectively billed Medicare, Medicaid, and private health insurers more than $27 billion.

Case descriptions can be found here, and court documents can be found here.