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.
No cases reported in Alaska!
That is because the cases are brought against the corporate cover only.
You will not know how many, if any are from Alaska. That is a fact of enforcement and business.
We will know when the go to trial now won’t we DK ?.
Medicaid travel fraud is huge in Alaska. The villagers come into larger towns to get their teeth fixed or toe nails clipped. They use travel vouchers to get from point A to B, using planes and taxis…..all paid by Medicaid. Once in town ,they go shopping and bar hopping. The common carriers inflate the amount normally charged and put the padding into their pockets and don’t report it as income. It’s a racket. It’s been going on for a long, long time. Dunleavy was correct to reel Medicaid back.
This is great news about something that would have never occurred had Kamala Harris managed to win the election. Hopefully, this is just the start and DOJ will soon be drilling farther down to individuals who benefit from this fraud.
This department has been around since at least 2007 what makes you think this wouldn’t have happened if Kamala was elected? From the article itself…
“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.”
Just a few numbers for context.
$27B over 18 years is an average of $1.5B a year.
Averaged across the 5400 defendants is $5M per defendent.
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This single crackdown is $14.6B and only 324 individuals. That averages to $45M per defendant.
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Rollo is likely correct. Had the 20224 election resulted in a Harris Presidency, the urgency placed on investigating fraud would remain at the level it has been over the last 18 years. This massive crackdown is a clear demonstration the current administration is serious.
Then the lefties all crowing about Medicaid cuts in the big beautiful bill ! Well how about the Biden administration using Medicaid for funding their illegal aliens . Billions and billions of dollars used the fund these absolute criminals who poured into the country with tax payer funded healthcare ? No mention ! Jakeem Jeffries , suck on this ! What a fool !
Sounds like our health care system will likely get healthier when the fraudulent bleeding stops.
Great article. Thank you, MRAK, for publishing this.
Gambling? I’m shocked!
I wonder what whistle blower filed the Qui Tam lawsuit that started this investigation? Since 3X damages can be recovered, that would be serious money.
The fraud was definitly happening in Alaska. Both myself and a friend of ours had notices that our procedures ( which we never had) were fully covered so no payments were required. We both reported to medicare and the investigation followed. The fraud is rampant.
IDE like to know where all the COVID money went. I sure see a lot of new office buildings owned by Dr groups around here. You don’t suppose they overcharged for testing do you ??
Where did all the money go?
Symptom: congestion; Diagnosis: COVID
Symptom: recurrent headache; Diagnosis: COVID
Symptom: rash; Diagnosis: COVID
Symptom: swollen/red/purple ankle; Diagnosis: COVID
Symptom: heartburn; Diagnosis: COVID
Symptom: pain or burning with urination; Diagnosis: COVID
Symptom: morning sickness; Diagnosis: COVID
Symptom: bloodshot eyes; Diagnosis: COVID
Symptom: radius bone protruding through forearm; Diagnosis: COVID
Symptom: severe descending pain on either side of your lower back; Diagnosis: COVID
Symptom: cycling depression; Diagnosis: COVID
Routine annual physical; Diagnosis: COVID
COVID test false-positive; Diagnosis: COVID
COVID test negative; Diagnosis: COVID
Exactly TSN. Bankrupt the entire planet over a flu bug. And the drama queens fell for it hook line and sinker. The freezer vans lined up for the dead body’s in the city’s. My god thinking back on all this bull shit.
Medicaid travel fraud is huge in Alaska. The villagers come into larger towns to get their teeth fixed or toe nails clipped. They use travel vouchers to get from point A to B, using planes and taxis…..all paid by Medicaid. Once in town ,they go shopping and bar hopping. The common carriers inflate the amount normally charged and put the padding into their pockets and don’t report it as income. It’s a racket. It’s been going on for a long, long time. Dunleavy was correct to reel Medicaid back.
Perhaps if this level of enforcement had been going on for decades, the cost of health care might be a bit lower. Oh… and cuts to medicare/medicaid would not be required.