In the largest coordinated health care fraud action in U.S. history, the Department of Justice charged 455 defendants-including 90 doctors and licensed medical professionals-across 45 states for false claims exceeding $6.5 billion.
Acting Attorney General Todd Blanche called the effort “the greatest whole-of-government operation” against health care fraud. FBI Director Kash Patel warned that “every arrest is a continued message to criminal actors who rob American taxpayers.”
Among the standout cases: • An Arizona corporate executive allegedly siphoned $1 billion from taxpayer funds via wound graft billing, using the proceeds to buy luxury homes, cars, and construct a hotel in the Philippines. • In Virginia, a mental health company co-owner is charged with a $49 million Medicaid scheme that bribed homeless individuals with hotel stays to use their Medicaid numbers for unneeded crisis services. • California prosecutors charged a hospice owner who obtained lists of deceased patients from a funeral home employee, paid kickbacks up to $3,000 per name, then back-dated fake records to bill Medicare for hospice care never provided.
CMS Administrator Dr. Mehmet Oz promised a shift from prosecution to prevention: “CMS is done playing catch-up. We’re deploying advanced data analytics to expose fraud networks, freeze suspicious payments, and shut down bad actors before they can do damage to the programs millions of Americans depend on.”
The takedown involved 56 federal districts and 50 state Medicaid Fraud Control Units, underscoring an unprecedented coordination between federal and state agencies.