D.O.J. ARRESTS 324 IN MASSIVE HEALTHCARE FRAUD TAKEDOWN
The Justice Department’s 2025 National Health Care Fraud Takedown resulted in charges against 324 defendants, including 96 medical professionals, across 50 federal districts and 12 states for health care fraud schemes causing over $14.6 billion in intended losses. The operation, led by the DOJ’s Health Care Fraud Unit with partners like HHS-OIG, FBI, and DEA, seized over $245 million in assets and prevented $4 billion in fraudulent claims through CMS actions. Key schemes included:
- Transnational Fraud: 29 defendants charged with $12 billion in fraudulent claims, including a $10.6 billion Medicare scam via Operation Gold Rush involving stolen identities and money laundering.
- Wound Care Fraud: Seven defendants charged with $1.1 billion in fraudulent Medicare claims for unnecessary amniotic wound allografts.
- Opioid Trafficking: 74 defendants, including 44 medical professionals, charged with diverting over 15 million opioid pills.
- Telemedicine/Genetic Testing Fraud: 49 defendants charged with $1.17 billion in fraudulent claims.
- Other Schemes: 170 defendants charged with $1.84 billion in fraudulent claims for unnecessary treatments and services.
The operation also introduced a Health Care Fraud Data Fusion Center to enhance detection using AI and analytics, aligning with a presidential executive order to reduce fraud through a whole-of-government approach.
