Healthcare Fraud Takedown: $14.6B Schemes, 324 Charged

The Justice Department, through its 2025 National Health Care Fraud Takedown investigation, has charged 324 defendants in schemes involving more than $14.6 billion in intended losses to Medicare, Medicaid and other government programs

Five things to know:

1. The 2025 operation was the largest in the department’s history, more than double the previous record of $6 billion, according to a June 30 department news release.

2. Those charged include 96 physicians, nurse practitioners, pharmacists and other licensed medical professionals.

3. CMS said it successfully prevented more than $4 billion from being paid in response to fraudulent claims. It also suspended or revoked the billing privileges of 205 providers in the months leading up to the takedown.

4. The government said it seized more than $245 million in cash, luxury vehicles, cryptocurrency and other assets as part of the operation.

5. The largest case of the investigation, dubbed Operation Gold Rush, involves the biggest alleged loss in any healthcare fraud case brought by the department. The $10.6 billion scheme involved 19 defendants — 12 of whom have been arrested, including four in Estonia. Prosecutors say the group used foreign straw owners, including individuals sent to the U.S., to buy dozens of medical supply companies. They allegedly submitted a surge of fraudulent Medicare claims for urinary catheters and other durable medical equipment using the stolen identities and medical data of more than 1 million Americans.

Read the full report here.