The Justice Department has announced the results of its 2025 National Health Care Fraud Takedown, which led to criminal charges against 324 defendants across the United States. These individuals, including 96 medical professionals, are accused of participating in health care fraud schemes involving over $14.6 billion in intended losses. This operation is described as the largest health care fraud takedown in history, surpassing previous records.
Attorney General Pamela Bondi said, “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.” The initiative involved multiple federal and state law enforcement agencies working together to combat fraud that exploits patients and taxpayers.
The Centers for Medicare and Medicaid Services (CMS) reported preventing over $4 billion from being paid out due to false claims. CMS also suspended or revoked billing privileges for 205 providers before the takedown. Civil charges were filed against 20 defendants for $14.2 million in alleged fraud, with civil settlements totaling $34.3 million announced.
Matthew R. Galeotti from the Justice Department’s Criminal Division emphasized their commitment to prosecuting health care fraud schemes that harm patients and contribute to issues like the opioid epidemic.
Acting Inspector General Juliet T. Hodgkins highlighted the unprecedented scale of this takedown and its impact on holding accountable those who exploit the federal health care system.
The operation also targeted transnational criminal organizations responsible for submitting fraudulent claims worth over $12 billion. Notably, Operation Gold Rush resulted in significant arrests and asset seizures related to these activities.
FBI Director Kash Patel noted that this effort demonstrates a strong commitment to pursuing those exploiting the system for personal gain, with more than $13 billion in fraud uncovered.
Charges were also brought against individuals involved in telemedicine and genetic testing fraud schemes totaling over $1.17 billion in fraudulent claims.
DEA Acting Administrator Robert Murphy commented on health care fraud as “trafficking in trust,” indicating that actions will be taken against those abusing their medical licenses for profit.
CMS Administrator Dr. Mehmet Oz said that advanced data analytics and real-time monitoring are crucial tools used by CMS to protect Medicare and Medicaid from waste, fraud, and abuse.
Overall, this coordinated nationwide law enforcement operation underscores a comprehensive approach involving various agencies working together to detect, investigate, and prosecute complex health care fraud schemes.
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