Doj Takes Down More Than $14 Billion Worth Of Health Care Fraud Schemes

The Justice Department says it has halted various wellness attraction schemes crossed nan state involving $14.6 cardinal successful intended loss. In a connection released Monday, June 30, nan DOJ says 324 group now look charges, including much than 90 aesculapian professionals.

2025 National Health Care Fraud Takedown

The section calls nan bust nan “2025 National Health Care Fraud Takedown.” It progressive 50 national districts and 12 authorities attorneys general’s offices.

They opportunity nan investigation helped rule enforcement prehend $245 cardinal successful cash, luxury vehicles, cryptocurrency and different assets.

“The Criminal Division is intensely committed to rooting retired wellness attraction fraud schemes and prosecuting nan criminals who perpetrate them because these schemes: (1) often consequence successful beingness diligent harm done medically unnecessary treatments aliases nonaccomplishment to supply nan correct treatments; (2) lend to our nationwide opioid pandemic and exacerbate controlled constituent addiction; and (3) do each of that while stealing money hardworking Americans lend to salary for nan attraction of their elders and different susceptible citizens,” said Matthew R. Galeotti, Head of nan Justice Department’s Criminal Division.

The Centers for Medicare and Medicaid Services besides says it successfully prevented much than $4 cardinal from being paid retired to fraudulent claims and suspended aliases revoked billing privileges for 20 providers.       

The different schemes busted by nan DOJ scope from transnational criminal organizations to fraudulent claims and medicine opioid trafficking.

Operation Gold Rush

Among those schemes is Operation Gold Rush, a $10.6 cardinal fraud scheme.

The cognition uncovered a scheme to acquisition much than 30 wellness attraction proviso companies already enrolled successful Medicare. Officials opportunity conspirators past utilized those companies to taxable a flood of claims for aesculapian equipment, including 1 cardinal urinary catheters.

“I don’t moreover cognize if [the United States] has nan expertise to manufacture 1 cardinal catheters successful specified a short time,” Isaac Bledsoe, head of strategical projects and initiatives astatine nan Department of Health and Human Services inspector general’s office, said to nan Washington Post. “The absurdity, nan brazenness of these actors is really conscionable astounding.”

Those bills were moreover passed connected to immoderate customers, according to The Post, including 73-year-old Gerald Quindry, who says his connection showed his supplier was billed for much than $15,000 worthy of catheters that his expert ne'er ordered.

Prescription opioid trafficking

As nan fallout continues from nan ongoing opioid epidemic, nan DOJ says 44 licensed aesculapian professionals are among those charged pinch moving much than 15 cardinal pills of medicine opioids.

The section says they were distributing oxycodone, hydrocodone and carisoprodol, which street-level dealers past trafficked.

“Today’s announcement shows that erstwhile doctors go supplier dealers and curen centers go profit-driven fraud rings, DEA will act,” said Acting Administrator Robert Murphy of nan DEA. “We’re targeting nan full ecosystem of fraud — from pill mills successful Texas to kickback clinics exploiting Native communities. If you maltreatment your aesculapian licence to push poison aliases pad your pockets, we will clasp you accountable.”

Telemedicine schemes

The DOJ says 49 group look charges successful relationship pinch complete $1.17 cardinal successful fraudulent claims stemming from telemedicine and familial testing fraud schemes. According to a recent study, 54% of Americans person now had a telemedicine visit.

The section gave an illustration of nan proprietor of telemedicine and durable aesculapian instrumentality companies successful South Florida. That proprietor is charged pinch a $46 cardinal strategy to target Medicare beneficiaries pinch deceptive telemarketing strategies to taxable fraudulent claims.

“The standard of today’s Takedown is unprecedented, and truthful is nan harm we’re confronting. Individuals who effort to bargain from nan national wellness attraction strategy and put susceptible patients astatine consequence will beryllium held accountable,” said Acting Inspector General Juliet T. Hodgkins of Health and Human Services, Office of Inspector General.