Federal authorities on Monday announced the results of a sweeping $14.6 billion health care fraud takedown, one of the largest in U.S. history. The nationwide crackdown resulted in criminal charges against 324 people, including 96 licensed medical professionals, and targeted schemes ranging from opioid pill mills to Medicare fraud.
The Justice Department, alongside federal and state law enforcement agencies, revealed that the 2025 National Health Care Fraud Takedown led to the seizure of over $245 million in cash, luxury vehicles, cryptocurrency, and other assets.
The Centers for Medicare & Medicaid Services (CMS) said it blocked more than $4 billion in false claims and revoked the billing privileges of 205 providers in recent months. Civil actions were also filed against 20 defendants over $14.2 million in alleged fraud, while settlements with 106 individuals totaled $34.3 million.
“These schemes not only defraud taxpayers — they often endanger patients with unnecessary or harmful treatments,” said Matthew Galeotti, head of the DOJ’s Criminal Division. “They fuel the opioid crisis, exploit vulnerable communities, and steal from programs designed to care for our elders and the poor.”
Major Findings and Operations:
Transnational Fraud Rings
Federal prosecutors charged 29 individuals linked to international criminal groups accused of submitting $12 billion in fraudulent health insurance claims. One group acquired dozens of medical supply companies to orchestrate their scam.
Operation Gold Rush alone led to charges against 19 people. Twelve were arrested — including four in Estonia — for allegedly exploiting the identities of over one million Americans to fraudulently bill $10.6 billion in Medicare claims for catheters and other supplies. Law enforcement prevented the bulk of payouts, but approximately $900 million was paid out by supplemental insurers. Authorities have recovered about $27.7 million so far.
Artificial Intelligence & Medicare ID Theft
In Illinois, prosecutors filed charges in a $703 million scheme involving the theft of Medicare ID numbers. Defendants allegedly used AI-generated voice recordings to fake consent from beneficiaries. The stolen data was sold to labs and equipment providers, resulting in fraudulent claims — with Medicare paying out $418 million. Authorities seized $44.7 million in this case.
Substandard Addiction Treatment Scam
A Pakistani and UAE-based billing company owner was charged with defrauding Arizona’s Medicaid program out of $650 million by billing for nonexistent or dangerously inadequate addiction treatment services. Some of the patients were recruited from Native American reservations and homeless populations. He allegedly laundered part of the proceeds to buy a $2.9 million home in Dubai.
Fraudulent Wound Care Treatment
Seven individuals — including five medical professionals — were charged in Arizona and Nevada for submitting $1.1 billion in fraudulent Medicare claims for unnecessary amniotic wound grafts. Some were applied to hospice patients without coordination with primary doctors and in ways that violated medical standards.
Opioid Trafficking
In 58 cases, 74 defendants — including 44 medical professionals — were charged with the illegal distribution of over 15 million opioid pills. In Texas, five people were linked to the unlawful dispensing of over 3 million pills through a single pharmacy. Street dealers then distributed the drugs for profit.
The DEA announced 93 administrative cases to revoke prescribing and dispensing privileges of medical professionals and pharmacies involved in controlled substance abuse.
Telemedicine and Genetic Testing Scams
Another 49 individuals were charged in schemes involving over $1.17 billion in fraudulent Medicare claims related to telehealth and genetic testing. One Florida case involved $46 million in fake durable medical equipment and testing charges driven by deceptive telemarketing campaigns.
Government Response
CMS Administrator Dr. Mehmet Oz praised the massive joint effort:
“Every dollar we prevent from going to fraudsters is a dollar that stays in the system to serve legitimate beneficiaries,” he said. “This takedown sends a clear message: we will not tolerate waste, fraud, or abuse in Medicare or Medicaid.”
The 2025 crackdown highlights the growing sophistication of health care fraud and the increasing use of AI, cross-border networks, and identity theft to exploit government programs — but also the growing tools law enforcement is using to detect and stop it.
