The US Department of Justice on Monday announced criminal charges against 324 individuals — including 96 licensed medical professionals — as part of the 2025 National Health Care Fraud Takedown. The operation spanned 50 federal districts and 12 State Attorneys General’s Offices and targeted alleged schemes that sought to defraud federal health care programs of more than $14.6 billion.
No cases were reported in Alaska, but transnational gangs and cartels figure strongly in this law enforcement sting.
The coordinated effort is touted as the largest in the DOJ’s history for health care fraud. It involved federal and state agencies across the nation, including the FBI, DEA, and the Department of Health and Human Services Office of Inspector General. The cases included fraud related to opioid distribution, telemedicine abuse, genetic testing, durable medical equipment scams, and money laundering operations tied to transnational criminal organizations.
In one of the most significant cases, a network of foreign-owned companies submitted $10.6 billion in fraudulent claims to Medicare using the stolen identities of more than one million Americans. The DOJ said 12 of the 19 defendants were arrested, including several captured in Estonia and at US border crossings, as part of “Operation Gold Rush.”
Among the 324 defendants charged were doctors, nurses, and pharmacists who allegedly engaged in fraudulent billing practices, illegal kickbacks, unnecessary medical procedures, and the distribution of opioids. More than 15 million pills of controlled substances were allegedly diverted in the schemes, which impacted vulnerable populations across the country, including Native American communities and the homeless.
Authorities also seized more than $245 million in cash, luxury vehicles, cryptocurrency, and other assets linked to the fraud schemes. Civil actions were brought against 20 additional defendants involving $14.2 million in alleged fraud, and civil settlements with 106 defendants totaled $34.3 million.
The Centers for Medicare and Medicaid Services (CMS), in a related enforcement measure, reported that it had prevented over $4 billion in fraudulent payments and suspended or revoked billing privileges for 205 providers leading up to the Takedown.
The DOJ is also launching a new Health Care Fraud Data Fusion Center to integrate data analysts from multiple agencies using cloud computing and AI to identify and respond to fraud in real time — part of an initiative tied to a presidential executive order to reduce waste, fraud, and abuse in federal programs.
“The Criminal Division is intensely committed to rooting out health care 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.”
“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. We are proud to stand with our law enforcement partners in protecting taxpayer dollars and safeguarding patient care.”
“Health care fraud drains critical resources from programs intended to help people who truly need medical care,” said FBI Director Kash Patel. “Today’s 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 health care systems.”
The DOJ emphasized that this year’s operation reflects a continuing, aggressive approach to uncovering and prosecuting health care fraud. Since 2007, the Department’s Health Care Fraud Strike Force has charged over 5,400 defendants for schemes totaling more than $27 billion in fraudulent billing.
“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.”
“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,” said Secretary Robert F. Kennedy Jr. of the Department of Health and Human Services.
Great article. Thank you, MRAK, for publishing this.
Gambling? I’m shocked!