DOJ Charges 324 in $14.6B Nationwide Health Care Fraud Bust

The Justice Department announced the 2025 National Health Care Fraud Takedown, charging 324 defendants involved in health care fraud schemes totaling $14.6 billion in intended losses across Medicare, Medicaid, and other programs, marking the largest such operation in DOJ history. Among those charged are 96 licensed medical professionals, and the government seized over $245 million in cash, luxury vehicles, cryptocurrency, and other assets, while preventing more than $4 billion in fraudulent claims from being paid. The largest case within the takedown, Operation Gold Rush, involves a $10.6 billion fraud scheme orchestrated by an international criminal organization, including 19 defendants who used foreign straw owners and stolen identities to submit bogus Medicare claims for durable medical equipment. Despite efforts to block most fraudulent payouts, the group collected $41 million from Medicare and $900 million from supplemental insurers. Efforts to prevent future fraud include suspending or revoking billing privileges of 205 providers and deploying AI and other tools by the Centers for Medicare and Medicaid Services to detect fraud faster. Officials emphasize that this crackdown signals a paradigm shift toward proactively stopping fraud before funds are disbursed, demonstrating a strong commitment to protecting taxpayer dollars and vulnerable populations relying on government health care programs.