The Justice Department says it has halted various health care schemes across the country involving $14.6 billion in intended loss. In a statement released Monday, June 30, the DOJ says 324 people now face charges, including more than 90 medical professionals.
2025 National Health Care Fraud Takedown
The department calls the bust the “2025 National Health Care Fraud Takedown.” It involved 50 federal districts and 12 state attorneys general’s offices.
They say the investigation helped law enforcement seize $245 million in cash, luxury vehicles, cryptocurrency and other assets.
“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 Centers for Medicare and Medicaid Services also says it successfully prevented more than $4 billion from being paid out to fraudulent claims and suspended or revoked billing privileges for 20 providers.
The different schemes busted by the DOJ range from transnational criminal organizations to fraudulent claims and prescription opioid trafficking.
Operation Gold Rush
Among those schemes is Operation Gold Rush, a $10.6 billion fraud scheme.
The operation uncovered a plan to purchase more than 30 health care supply companies already enrolled in Medicare. Officials say conspirators then used those companies to submit a flood of claims for medical equipment, including one billion urinary catheters.
“I don’t even know if [the United States] has the ability to manufacture 1 billion catheters in such a short time,” Isaac Bledsoe, director of strategic projects and initiatives at the Department of Health and Human Services inspector general’s office, said to the Washington Post. “The absurdity, the brazenness of these actors is really just astounding.”
Those bills were even passed on to some customers, according to The Post, including 73-year-old Gerald Quindry, who says his statement showed his provider was billed for more than $15,000 worth of catheters that his doctor never ordered.
Prescription opioid trafficking
As the fallout continues from the ongoing opioid epidemic, the DOJ says 44 licensed medical professionals are among those charged with moving more than 15 million pills of prescription opioids.
The department says they were distributing oxycodone, hydrocodone and carisoprodol, which street-level dealers then trafficked.
“Today’s announcement shows that when doctors become drug dealers and treatment centers become profit-driven fraud rings, DEA will act,” said Acting Administrator Robert Murphy of the DEA. “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 schemes
The DOJ says 49 people face charges in connection with over $1.17 billion in fraudulent claims stemming from telemedicine and genetic testing fraud schemes. According to a recent study, 54% of Americans have now had a telemedicine visit.
The department gave an example of the owner of telemedicine and durable medical equipment companies in South Florida. That owner is charged with a $46 million scheme to target Medicare beneficiaries with deceptive telemarketing tactics to submit fraudulent claims.
“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 Health and Human Services, Office of Inspector General.
