Hundreds Charged in $14.6B DOJ Healthcare Fraud Case

The Department of Justice on Monday reported initial results from its coordinated takedown of healthcare fraud amounting to over $14.6 billion and the arrests of 324 defendants, including nearly 100 doctors, nurse practitioners, pharmacists, and other licensed medical professionals.

The department called its 2025 national fraud takedown the largest law enforcement sweep in U.S. history, targeting "fraud schemes that exploit patients and taxpayers."

Twenyt-nine defendants were charged for their roles in what is described as a "transnational criminal organization" by the DOJ. Many of those involved have been arrested, including some arrests at airports, as the alleged fraudsters were trying to escape. The group set up fake medical supply companies and, in short order, billed the government for $10.6 billion in fraudulent Medicare claims using stolen identities of over 1 million Americans from all 50 states.

Additionally, the Centers for Medicare and Medicaid Services announced that it had prevented over $4 billion from being paid out by the government to fraudulent claims, where it had suspended or revoked billing access by more than 200 providers. Civil charges against 20 healthcare providers connected to those claims have been filed, and settlements with another 100 people charged with fraud have been secured for over $34 million.

Health and Human Services Agency Secretary Robert F. Kennedy Jr. said his department assisted law enforcement agents in the massive effort to stop the thievery. "As part of making healthcare accessible and affordable to all Americans, HHS will aggressively work with our law enforcement partners to eliminate the pervasive healthcare fraud that bedeviled this agency under the former administration and drove up costs."

The DOJ said some of the cases in the sweep ended up with narcotics being sold on the street and that it stopped a group of people connected with a Texas pharmacy from obtaining massive quantities of oxycodone, hydrocodone, and carisoprodol, "which were subsequently trafficked by street-level drug dealers, generating large profits for the defendants."

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