In an unprecedented crackdown on fraudulent healthcare activity, the U.S. Department of Justice (DOJ) has dismantled a sprawling web of scams aimed at draining billions from government healthcare programs, including Medicare and Medicaid.
Federal authorities announced on Monday that 324 individuals, including 93 licensed medical professionals, are facing criminal charges tied to schemes that attempted to defraud the federal government of an estimated $14.6 billion. The Justice Department is calling it the largest healthcare fraud operation in U.S. history.
“A decisive moment” in fighting healthcare fraud
Matthew Galeotti, who leads the DOJ’s Criminal Division, said during a press briefing that the operation sends a strong signal to those looking to exploit the nation’s healthcare system.
“Today marks a decisive moment in our fight to protect American taxpayers from fraudsters and to defend the integrity of America’s healthcare system,” he stated.
While the total attempted fraud stood at $14.6 billion, investigators say the actual financial loss to the government reached approximately $2.9 billion. Law enforcement officials recovered over $245 million in stolen funds and assets—including luxury vehicles and cash—during the nationwide operation.
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Foreign crime syndicates behind complex fraud networks
Justice officials noted that some of the most elaborate scams were orchestrated by international criminal organizations based in Eastern Europe and Russia. One such network involved a sophisticated scheme to create fake medical supply companies across the U.S.
Prosecutors say 19 people have been charged in connection to that ring—12 of whom have already been apprehended. Using a network of foreign straw buyers and stolen identities of U.S. citizens, the group filed over $10 billion in false Medicare claims.
Real victims caught in the crossfire
One of the innocent Americans caught up in the scheme was Gerald Quindry, a 73-year-old retired engineer enrolled in Medicare. Quindry discovered he had been billed $15,500 for urinary catheters—items he never ordered, needed, or received.
Despite flagging the suspicious charge to Medicare, Quindry said he initially received little support from the agency. “Obviously, somebody deserves to be in jail,” he told The Washington Post, expressing frustration at the delayed response.
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High-level response from federal agencies
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services (CMS), emphasized the organized nature of these operations:
“This isn’t small-time fraud. These are highly coordinated criminal syndicates targeting our nation’s most vital programs.”
Authorities say many of the charged individuals worked together across state and national borders, leveraging increasingly sophisticated methods to exploit weaknesses in the healthcare system.
The road ahead
As the DOJ pushes forward with prosecutions, officials say the broader goal is to reinforce oversight and close the systemic gaps that allow these schemes to thrive. The Biden administration has prioritized healthcare fraud prevention, which costs taxpayers billions annually and undermines care for those who need it most.
The DOJ’s crackdown reflects a renewed commitment to safeguarding Medicare, Medicaid, and the identities of everyday Americans from the growing threat of healthcare fraud.
